A non-invasive biomechanical device and treatment for patients following total hip arthroplasty: results of a 6-month pilot investigation

The effect of treatment with a non-invasive foot worn biomechanical device on subjective and objective measures in patients with knee osteoarthritis- a retrospective analysis on a UK population

Background

Osteoarthritis is a major cause of pain and disability worldwide, therefore ways of treating this condition are paramount to a successful health system. The purpose of the study was to investigate the changes in spatial-temporal gait parameters and clinical measurements following treatment with a non-invasive foot-worn biomechanical device on patients with knee osteoarthritis within the UK.

Methods

A retrospective analysis was carried out on 455 patients with knee osteoarthritis. All patients were evaluated using a computerized gait test and two self-assessment questionnaires (WOMAC and SF-36) at baseline and after 3 and 6 months of treatment. The biomechanical device is a shoe-like device with convex pods under the sole that have the capability of changing foot centre of pressure and training neuromuscular control. The device was individually calibrated for each patient to minimise symptoms whilst walking and train neuromuscular control. Patients used the device for short periods during activities of daily living. Repeated measures statistical analyses were performed to compare differences over time.

Results

After 6 months of treatment significant improvements were seen in all gait parameters (p < 0.01). Specifically, gait velocity, step length and single limb support of the more symptomatic knee improved by 13, 7.8 and 3%, respectively. These were supported by significant improvements in pain, function and quality of life (48.6, 45.7 and 22% respectively; p < 0.001). A sub-group analysis revealed no baseline differences between those who were recommended joint replacement and those who were not. Both groups improved significantly over time (p < 0.05 for all).

Conclusions

Our results suggest that the personalised biomechanical treatment can improve gait patterns, pain, function and quality of life. It may provide an additional solution to managing UK patients suffering from knee osteoarthritis but needs to be tested in a controlled setting first.

Patients with chronic non-specific low back pain who reported reduction in pain and improvement in function also demonstrated an improvement in gait pattern

PURPOSE

To assess the changes in gait pattern and clinical symptoms of patients with chronic non-specific low back pain (CNSLBP) following a home-based biomechanical treatment (HBBT).

METHODS

This was a retrospective analysis of 60 CNSLBP patients. All patients underwent a gait evaluation and completed self-assessment questionnaires at pre-treatment and after 3 and 6 months of a HBBT (AposTherapy). Twenty-four healthy, aged-matched individuals served as a reference group.

RESULTS

Significant differences were found in all gait parameters and clinical symptoms between patients with CNSLBP and healthy people before treatment. Significant improvements were found in all gait parameters and clinical measures following 6 months of therapy including an increase in gait velocity (10.6 %), step length (5.6 %), cadence (5 %), and quality of life and a decrease in pain (13.3 %). There were no significant differences between groups in the gait parameters following 6 months of treatment.

CONCLUSIONS

Significant differences exist between patients with CNSLBP and healthy controls in terms of gait pattern and self-assessed health status. The examined HBBT led to significant improvements in gait pattern, reduction in pain, improved function and increased quality of life. However, future studies should validate these results while comparing this treatment to other treatment modalities.