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Telerehabilitation Gait Modification (TELEMOD)

University of British Columbia logo

University of British Columbia

Status

Completed

Conditions

Osteoarthritis, Knee

Treatments

Behavioral: Foot rotation modification
Other: Waiting Period - Delayed Group

Study type

Interventional

Funder types

Other

Identifiers

NCT04683913
H20-03086

Details and patient eligibility

About

Excessive knee joint loads during walking can contribute to knee osteoarthritis progression. Changing the rotation of the foot (in-toeing or out-toeing) while walking can lower knee joint loads and improve pain and function. Telerehabilitation (using video or telephone communication to delivery rehabilitation) has shown promise in delivering exercise therapy for knee osteoarthritis, but it is unknown if walking modifications can be delivered using this method. This study consists of a six-week walking modification program in people with knee osteoarthritis. Performance of the modification will be measured using motion capture and wearable sensors during practice and daily life.

Full description

Loads on the knee joint during walking are related to worsening of knee osteoarthritis. Changing walking motions to lower these knee joint loads is an emerging management strategy for knee osteoarthritis. Multiple studies have targeted a change in the position of the foot relative to the direction of walking (toe-in or toe-out walking) and have shown this walking modification to lower knee joint loads and improve symptoms (e.g. pain) related to knee osteoarthritis within the context of a walking program. Building off the many studies that have found telerehabilitation to be an effective method of providing exercise and pain-coping physical therapy, the investigators will use this method to provide walking modification treatment. Telerehabilitation (using video or teleconferencing to conduct the physical therapy appointment) provides a convenient and cost-effective method to work with patients and coordinate their treatment plan. To monitor progress with learning the walking modification, the investigators will use a custom sensor shoe that the participants will wear during daily walking activities over the six-week intervention. Overall, this study will investigate the feasibility and effectiveness of a walking modification program delivered using video- or teleconference.

Enrollment

20 patients

Sex

All

Ages

50+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • 50 years of age or older
  • Exhibit signs of tibiofemoral osteoarthritis based on a score of ≥2 on the Kellgren and Lawrence grading scale predominantly in the medial compartment.
  • Self-reported knee pain ≥ 3 / 10 on a numerical rating scale of pain (NRS; 0 = "no pain" and 10 = "worst pain imaginable") during most days of the previous month
  • Comfortable walking intermittently for 30 minutes
  • Fit into the available sizes of sensor shoes (between US women's 5 to men's 13)
  • Exhibits ≥2% reduction in knee adduction moment impulse at 10 degrees of change in toe-in or toe-out during the screening appointment.

Exclusion criteria

  • Any knee surgery or intraarticular injections within the past 6 months
  • A history of joint replacement surgery or high tibial osteotomy
  • Current or recent (within 6 weeks) corticosteroid injections
  • Use of a gait aid
  • Currently on a wait list for joint replacement surgery or high tibial osteotomy
  • Any inflammatory arthritic condition
  • Any other conditions that may affect normal gait or participation in an aerobic exercise program
  • Cannot attend all required appointments

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

None (Open label)

20 participants in 2 patient groups

Immediate Intervention: Telerehabilitation
Experimental group
Description:
Immediate entry into the gait modification intervention delivered using teleconferencing methods
Treatment:
Behavioral: Foot rotation modification
Delayed Intervention: Telerehabilitation
Experimental group
Description:
Delayed (6 weeks) entry into the gait modification intervention delivered using teleconferencing methods
Treatment:
Other: Waiting Period - Delayed Group
Behavioral: Foot rotation modification

Trial documents
2

Trial contacts and locations

1

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Central trial contact

Natasha Krowchuk, BSc; Michael Hunt, PT, PhD

Data sourced from clinicaltrials.gov

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