Rayane Quintão Castro, João Victor Volker Oliveira, Priscila Monteiro Veras, Cyntia Pace Schmitz Correa, Jennifer Granja Peixoto, Diogo Simões Fonseca
{"title":"步态再训练策略对膝关节骨关节炎患者临床和生物力学结果的影响：一项荟萃分析和GRADE推荐的系统综述。","authors":"Rayane Quintão Castro, João Victor Volker Oliveira, Priscila Monteiro Veras, Cyntia Pace Schmitz Correa, Jennifer Granja Peixoto, Diogo Simões Fonseca","doi":"10.1080/09638288.2025.2502586","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To assess the effects of gait retraining strategies on clinical and/or biomechanical variables in knee osteoarthritis.</p><p><strong>Methods: </strong>This study was registered in PROSPERO-CRD42023402778. Studies were searched up to June/2024. PEDro scale and GRADE approach were used to assess methodological quality and certainty of evidence. A meta-analysis was conducted using R-software.</p><p><strong>Results: </strong>The included studies employed backward walking (5), toe-out (1), and freely strategies (2). The meta-analysis revealed a significant difference with low quality of evidence favoring gait retraining for pain (MD = -1.12; 95% CI: [-1.61; -0.62]; I<sup>2</sup> = 78%; <i>p</i> < 0.01) and with high quality for function (SMD = -0.80; 95% CI: [-1.12; -0.48]; I<sup>2</sup> = 0%; <i>p</i> = 0.42). A significant difference also favoring gait retraining was observed for first knee adduction moment (KAM) (MD = -0.20; 95% CI: [-0.38; -0.02]; I<sup>2</sup> = 84%; <i>p</i> < 0.01). The comparisons indicated similarity between groups for second KAM (MD = -0.16; 95% CI: [-0.47; 0.16]; I<sup>2</sup> = 79%; <i>p</i> = 0.03) and for knee flexion moment (MD = 0.07; 95% CI: [-0.07; 0.20]; I<sup>2</sup> = 76%; <i>p</i> = 0.02).</p><p><strong>Conclusion: </strong>Gait retraining improved pain, function and first KAM. Second KAM and knee flexion moment did not modify.</p>","PeriodicalId":50575,"journal":{"name":"Disability and Rehabilitation","volume":" ","pages":"1-9"},"PeriodicalIF":2.1000,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effect of gait retraining strategies on clinical and biomechanical outcomes in subjects with knee osteoarthritis: a systematic review with meta-analysis and GRADE recommendations.\",\"authors\":\"Rayane Quintão Castro, João Victor Volker Oliveira, Priscila Monteiro Veras, Cyntia Pace Schmitz Correa, Jennifer Granja Peixoto, Diogo Simões Fonseca\",\"doi\":\"10.1080/09638288.2025.2502586\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To assess the effects of gait retraining strategies on clinical and/or biomechanical variables in knee osteoarthritis.</p><p><strong>Methods: </strong>This study was registered in PROSPERO-CRD42023402778. Studies were searched up to June/2024. PEDro scale and GRADE approach were used to assess methodological quality and certainty of evidence. A meta-analysis was conducted using R-software.</p><p><strong>Results: </strong>The included studies employed backward walking (5), toe-out (1), and freely strategies (2). The meta-analysis revealed a significant difference with low quality of evidence favoring gait retraining for pain (MD = -1.12; 95% CI: [-1.61; -0.62]; I<sup>2</sup> = 78%; <i>p</i> < 0.01) and with high quality for function (SMD = -0.80; 95% CI: [-1.12; -0.48]; I<sup>2</sup> = 0%; <i>p</i> = 0.42). A significant difference also favoring gait retraining was observed for first knee adduction moment (KAM) (MD = -0.20; 95% CI: [-0.38; -0.02]; I<sup>2</sup> = 84%; <i>p</i> < 0.01). The comparisons indicated similarity between groups for second KAM (MD = -0.16; 95% CI: [-0.47; 0.16]; I<sup>2</sup> = 79%; <i>p</i> = 0.03) and for knee flexion moment (MD = 0.07; 95% CI: [-0.07; 0.20]; I<sup>2</sup> = 76%; <i>p</i> = 0.02).</p><p><strong>Conclusion: </strong>Gait retraining improved pain, function and first KAM. Second KAM and knee flexion moment did not modify.</p>\",\"PeriodicalId\":50575,\"journal\":{\"name\":\"Disability and Rehabilitation\",\"volume\":\" \",\"pages\":\"1-9\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-05-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Disability and Rehabilitation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/09638288.2025.2502586\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Disability and Rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/09638288.2025.2502586","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}
Effect of gait retraining strategies on clinical and biomechanical outcomes in subjects with knee osteoarthritis: a systematic review with meta-analysis and GRADE recommendations.
Purpose: To assess the effects of gait retraining strategies on clinical and/or biomechanical variables in knee osteoarthritis.
Methods: This study was registered in PROSPERO-CRD42023402778. Studies were searched up to June/2024. PEDro scale and GRADE approach were used to assess methodological quality and certainty of evidence. A meta-analysis was conducted using R-software.
Results: The included studies employed backward walking (5), toe-out (1), and freely strategies (2). The meta-analysis revealed a significant difference with low quality of evidence favoring gait retraining for pain (MD = -1.12; 95% CI: [-1.61; -0.62]; I2 = 78%; p < 0.01) and with high quality for function (SMD = -0.80; 95% CI: [-1.12; -0.48]; I2 = 0%; p = 0.42). A significant difference also favoring gait retraining was observed for first knee adduction moment (KAM) (MD = -0.20; 95% CI: [-0.38; -0.02]; I2 = 84%; p < 0.01). The comparisons indicated similarity between groups for second KAM (MD = -0.16; 95% CI: [-0.47; 0.16]; I2 = 79%; p = 0.03) and for knee flexion moment (MD = 0.07; 95% CI: [-0.07; 0.20]; I2 = 76%; p = 0.02).
Conclusion: Gait retraining improved pain, function and first KAM. Second KAM and knee flexion moment did not modify.
期刊介绍：
Disability and Rehabilitation along with Disability and Rehabilitation: Assistive Technology are international multidisciplinary journals which seek to encourage a better understanding of all aspects of disability and to promote rehabilitation science, practice and policy aspects of the rehabilitation process.
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