Gait Retraining to Reduce Tibial Acceleration Versus a Standard Walking Program for Reducing Knee Pain and Loading in Adults With Knee Osteoarthritis: A Randomized Feasibility Trial.

Objective: To assess the feasibility of a randomized controlled trial evaluating a gait retraining program to reduce peak tibial acceleration on knee pain and impact loading in adults with knee osteoarthritis.

Methods: Participants (n = 44) were randomized to a gait retraining or standard walking program. Walking duration increased from 10 to 30 minutes as feedback faded over eight sessions. Gait retraining participants received real-time biofeedback to reduce peak tibial acceleration by 20%. Feasibility criteria included rates of recruitment, enrollment, and retention and number of adverse events. Knee pain and overground impact loading were assessed at baseline and one week after the last treadmill session. Analysis of covariance models compared group differences in peak tibial acceleration, pain, and impact loading after the walking program, controlling for baseline values.

Results: Most feasibility criteria were met. From 2019 to 2023, 867 individuals were screened (~22 individuals per month), and 46 were enrolled and randomized (n = 23 per group). No adverse events were identified. Peak tibial acceleration reduced by 0.13g and 0.09g (gravitational equivalents) for the gait retraining and standard walking groups, respectively. Greater reductions in pain were observed for the standard walking group compared to the gait retraining group. Changes in impact loading were not significant in either group. No between-group differences were observed for peak tibial acceleration, knee pain, or impact loading.

Conclusion: A full-scale randomized clinical trial is feasible with modification. However, gait retraining to reduce peak tibial acceleration was no more effective than a standard walking program for reducing knee pain and impact loading.