Effects of Movement Retraining on Knee Loading in Individuals With Knee Osteoarthritis

NCT06208631 | Recruiting

• 1 other identifier: 34928
• Study Type: interventional
• Target: 31
• Locations: 1 country
• Sites: 1

Brief Summary

This study investigates how well individuals with knee osteoarthritis can learn to alter their calf muscle activation using haptic biofeedback while walking and evaluates how these changes affect knee loading. Prior research has utilized musculoskeletal simulations to determine that reducing the activation of one of the calf muscles, the gastrocnemius, can have a large impact on reducing knee loading. However, this has not been tested in individuals with knee osteoarthritis. In this study, participants will be trained to alter the activation of their gastrocnemius muscle, by receiving haptic feedback after each step. The feedback will indicate how the participant changed their muscle activation relative to baseline. Some participants will train on a treadmill in the laboratory for up to two sessions, with 30 minutes of walking with feedback in each session. If a participant can learn to adjust their muscle activation in the first training session, they will be able to complete the second training session. Other participants will train outside the laboratory for one session with 30 minutes of walking with feedback to investigate changes in knee loading while using the new walking strategy during over-ground walking. The movement data collected during the training sessions will be used as inputs to computer simulations of the musculoskeletal system to determine if walking with the new muscle activation strategy reduces knee loading.

Conditions

Osteoarthritis, Knee

Outcome Measures

Primary Outcomes (1)

• Change from baseline in knee contact force

  Knee contact force will be evaluated using motion capture data and musculoskeletal modeling and simulations, for participants that are able to reduce gastrocnemius activation.

  Evaluated during the 30 minutes of feedback walking in the second in-lab session and out-of-lab session

Secondary Outcomes (3)

• Change from baseline in gastrocnemius activation

  Evaluated during the 30 minutes of feedback walking in the first in-lab session, the second in-lab session, and the out-of-lab session

• Proportion of participants that reduce gastrocnemius activation

  Evaluated during the 30 minutes of feedback walking in the first in-lab session, the second in-lab session, and the out-of-lab session

• Proportion of participants that reduce knee contact force

  Evaluated during the 30 minutes of feedback walking in the second in-lab session and the out-of-lab session

Study Arms (1)

Gait modification

EXPERIMENTAL

Participants will learn to change muscle coordination while walking through real-time haptic biofeedback based on the activation of the gastrocnemius muscle

Behavioral: Gait retraining

Interventions

Gait retraining BEHAVIORAL

Changing muscle coordination while walking

Gait modification

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Medial and/or lateral compartment knee osteoarthritis
• Diagnosed with knee osteoarthritis of at least six months duration
• Ambulatory without aids
• Able to walk for at least 60 minutes
• Typical pain rating less than or equal to 4 on scale of 0-10
• Able to reduce gastrocnemius muscle activation by 10% from baseline

You may not qualify if:

• History of symptomatic arthritis in lower limb joints other than the knees
• Replacement of any lower extremity joint
• Symptoms originating from the patellofemoral joint
• Body mass index equal to or greater than 35
• Nerve or muscle disease associated with walking difficulty
• History of rheumatoid arthritis, gout, or autoimmune disease
• History of lower limb fracture or surgery requiring hospitalization
• Pregnant

Sponsors & Collaborators

• Stanford University: lead

Study Sites (1)

Stanford Human Performance Lab

Stanford, California, 94305, United States

RECRUITING

Related Publications (2)

• Lee KJ, Hahm KB, Kim YS, Kim JH, Cho SW, Jie H, Park CH, Yim H. The usefulness of Tc-99m HMPAO labeled WBC SPECT in eosinophilic gastroenteritis. Clin Nucl Med. 1997 Aug;22(8):536-41. doi: 10.1097/00003072-199708000-00005.

  PMID: 9262899 BACKGROUND

• Kather L, Smidt D. [Composition of porcine uterine secretion]. Berl Munch Tierarztl Wochenschr. 1974 Oct 1;87(19):372-4. No abstract available. German.

  PMID: 4409006 BACKGROUND

MeSH Terms

Conditions

Osteoarthritis, Knee

Condition Hierarchy (Ancestors)

Osteoarthritis; Arthritis; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases

Study Officials

• Scott L Delp, PhD

  Stanford University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Study Team

CONTACT

650-721-2547; oawalking@lists.stanford.edu

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: OTHER
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor of Bioengineering and Mechanical Engineering

Study Record Dates

• First Submitted: December 18, 2023
• First Posted: January 17, 2024
• Study Start: January 18, 2024
• Primary Completion (Estimated): December 1, 2026
• Study Completion (Estimated): December 1, 2026
• Last Updated: October 9, 2025

Record last verified: 2025-10

Data Sharing

• IPD Sharing: Will share
• Time Frame: After publication and no end date
• Access Criteria: Data will be publicly available online at SimTK.

Locations

US (1)