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Movement Retraining using Real-time Feedback of Performance
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Unsupervised gait retraining using a wireless pressure-detecting shoe insole.

Jade He1, Kevin Lippmann1, Najia Shakoor1

  • 1Department of Orthopedic Surgery, Rush University Medical Center, 1611 W Harrison Street, Suite 201, Chicago, IL 60612, USA.

Gait & Posture
|April 16, 2019
PubMed
Summary

Wireless shoe insoles with auditory feedback effectively reduced knee adduction moment (KAM) in healthy subjects. This technology shows promise for gait retraining in knee osteoarthritis (OA) patients.

Keywords:
FeedbackGait modificationKnee adduction momentOsteoarthritisWireless sensor insole

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Area of Science:

  • Biomechanics
  • Orthopedics
  • Rehabilitation Engineering

Background:

  • The knee adduction moment (KAM) quantifies knee joint loading and correlates with knee osteoarthritis (OA) severity.
  • Current biomechanical interventions to reduce KAM have variable effectiveness.
  • A novel wireless, pressure-detecting shoe insole system with smartphone-based auditory feedback was developed.

Purpose of the Study:

  • To determine if auditory cues from a smartphone can guide individuals to adjust their gait and decrease KAM.
  • To evaluate the efficacy of a wireless insole system for gait retraining.

Main Methods:

  • Nineteen healthy subjects participated in a two-phase gait training study.
  • Phase 1 involved supervised in-lab training with auditory feedback to medialise foot center-of-pressure (COP).
  • Phase 2 involved unsupervised training with continued auditory cues during campus walking.

Main Results:

  • Subjects achieved a significant 20.6% reduction in KAM after Phase 1 (p=0.001).
  • Continued unsupervised training in Phase 2 resulted in a sustained 17.2% KAM reduction (p<0.001) without auditory cues.
  • Reduced adduction angular impulse was observed (p=0.001) despite a slight decrease in walking speed.

Conclusions:

  • Wireless insole technology with auditory feedback is effective for gait retraining to lower KAM.
  • This system represents a promising tool for future home-based clinical trials for knee OA management.