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Session: Poster session II
Session starts: Thursday 24 January, 16:00

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Sanne Roeles ()
Frans Steenbrink ()
Josien van den Noort ()
Jaap Harlaar ()

Abstract:
Gait retraining with real-time visual feedback on well chosen gait parameters may have potential to treat pathological gait patterns [1]. Especially the Knee Adduction Moment (KAM) is a relevant target parameter in patients with Knee Osteoarthritis (KO). In this study we evaluate the feasibility of real-time visual feedback. Four types of feedback on both a kinematic and a kinetic gait parameter were used on healthy subjects to modify their gait pattern. It was hypothesized that visual feedback of both kinematic and kinetic parameters is an effective technique for gait pattern modification. Subsequently possible effect size differences between different types of visual feedback were investigated. Healthy subjects (8 males; age 28±7.6y) walked on the GRAIL (Gait Real-time Analysis Interactive Lab; dual-belt instrumented treadmill, motion-capture system and virtual reality (Motek Medical B.V.)). Compared to a baseline recording subjects were asked to increase internal hip rotation or decrease knee adduction moment based on four types of visual feedback, i.e. bar, polar plot, color changes, graph. With visual feedback hip rotation increased (P=0.001; baseline: 3.03±7.27°, bar: 9.23±9.64°, polar plot: 12±13°, color: 10±13°, graph: 10±13°) and knee adduction moment decreased (P<0.001; baseline: 0.4±0.1 Nm/kg, bar: 0.2±0.2 Nm/kg, polar plot: 0.2±0.1 Nm/kg, color: 0.2±0.2 Nm/kg, graph: 0.2±0.1 Nm/kg) compared to baseline levels. The amount of change in the gait parameters was not significantly influenced by the type of visual feedback. Real-time visual feedback can be used to modify subject specific gait parameters in healthy controls and can potentially be used for gait retraining in patients. Our findings demonstrate the potential of these techniques for conservative treatment of KO patients by active and dynamic KAM reduction, potentially postponing knee replacement. The effect-size of the modified gait pattern was not influenced by the type of feedback, suggesting that the type of visual feedback is not of primary concern. REFERENCES [1] Wheeler, J., et al. (2011). Real-time knee adduction moment feedback for gait retraining through visual and tactile displays. Journal of Biomechanical Engineering 133, 1-4.