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No effects of functional exercise therapy on walking biomechanics in patients with knee osteoarthritis: exploratory outcome analyses from a randomised trial
  1. Marius Henriksen1,2,
  2. Louise Klokker1,
  3. Cecilie Bartholdy1,2,
  4. Tanja Schjoedt-Jorgensen1,
  5. Elisabeth Bandak1,
  6. Henning Bliddal1
  1. 1 The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
  2. 2 Department of Physical and Occupational Therapy, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
  1. Correspondence to Dr Marius Henriksen; Marius.Henriksen{at}regionh.dk

Abstract

Aim To assess the effects of a functional and individualised exercise programme on gait biomechanics during walking in people with knee OA.

Methods Sixty participants were randomised to 12 weeks of facility-based functional and individualised neuromuscular exercise therapy (ET), 3 sessions per week supervised by trained physical therapists, or a no attention control group (CG). Three-dimensional gait analyses were used, from which a comprehensive list of conventional gait variables were extracted (totally 52 kinematic, kinetic and spatiotemporal variables). According to the protocol, the analyses were based on the ‘Per-Protocol’ population (defined as participants following the protocol with complete and valid gait analyses). Analysis of covariance adjusting for the level at baseline was used to determine differences between groups (95% CIs) in the changes from baseline at follow-up.

Results The per-protocol population included 46 participants (24 ET/22 CG). There were no group differences in the analysed gait variables, except for a significant group difference in the second peak knee flexor moment and second peak vertical ground reaction force.

Conclusion While plausible we have limited confidence in the findings due to multiple statistical tests and lack of biomechanical logics. Therefore we conclude that a 12-week supervised individualised neuromuscular exercise programme has no effects on gait biomechanics. Future studies should focus on exercise programmes specifically designed to alter gait patterns, or include other measures of mobility, such as walking on stairs or inclined surfaces.

Trial registration number ClinicalTrials.gov: NCT01545258.

  • Knee osteoarthritis
  • Exercise therapy
  • gait analysis
  • randomized controlled trial.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Contributors MH is responsible for the integrity of the work.

    MH: Conception, design, analysis and interpretation, manuscript drafting, critical revision of the manuscript for important intellectual content, final approval of the manuscript.

    LK: Study coordination, data acquisition, analysis and interpretation, critical revision of the manuscript for important intellectual content, final approval of the manuscript.

    CB: Intervention delivery, data acquisition, analysis and interpretation, critical revision of the manuscript for important intellectual content, final approval of the manuscript.

    TS-J: Data acquisition, analysis and interpretation, critical revision of the manuscript for important intellectual content, final approval of the manuscript.

    EB: Study coordination, data acquisition, analysis and interpretation, critical revision of the manuscript for important intellectual content, final approval of the manuscript.

    HB: Conception, design, analysis and interpretation, manuscript drafting, critical revision of the manuscript for important intellectual content, final approval of the manuscript.

  • Competing interests None declared.

  • Ethics approval The Health Research Ethics Committee of the Capital Region of Denmark.

  • Provenance and peer review Not commissioned; internally peer reviewed.