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Published on: October 6, 2020
Sensor-Based Quantitative Gait Improvements Following Genicular Nerve Block in Patients with Knee Osteoarthritis
Megha Bhargava1, Ravi Gaur2, Nitesh Manohar Gonnade2
1Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences [AIIMS], New Delhi, India.
Background:
The goals of rehabilitation in knee osteoarthritis are adequate pain relief, functional improvement, and prevention of psychological deconditioning. Gait abnormalities in osteoarthritis patients have been studied using gait analyses. Genicular nerve block (GNB) is used for knee osteoarthritis (OA) related pain, but its impact on objective gait biomechanics remains underreported.
Aim:
To evaluate and compare spatiotemporal gait improvements at baseline and after 6 months of ultrasound-guided GNB in patients with knee OA using wearable sensor-based assessment.
Methods:
Fifty-one patients with knee OA (Kellgren-Lawrence Grade II-IV) who underwent ultrasound-guided GNB in the Department of Physical Medicine & Rehabilitation, AIIMS Jodhpur were assessed for cadence, affected knee propulsion, stance phase duration, and Timed Up and Go (TUG) using the G-Walk sensor pre and 6 months post-procedure. Statistical tests included paired t-tests, Wilcoxon signed-rank, and Mann-Whitney U Test.
Results:
Significant improvements in spatiotemporal gait parameters were observed at 6 months post-procedure compared to baseline. Cadence improved from 94.13 ± 9 to 109.02 ± 9.38 steps/min (P < .0001), propulsion from 4.47 ± 1.2 to 6.11 ± 1 W/kg (P < .0001), and stance duration from 57.8% to 59.9% (P < .0001). TUG time decreased from 19.12 to 12.67 seconds (P < .0001). Propulsion gain was lower in patients with comorbidities (P = .047).
Conclusion:
Sensor-based gait assessment offers an objective, quantifiable means to measure the impact of pain interventions in musculoskeletal rehabilitation. Pain alleviating interventions like GNB yield measurable gait improvements in knee OA. Adequate pain relief promotes active rehabilitation, enhancing biomechanics and mobility.
Self Declaration:
This is a secondary analysis of data previously collected as part of a published study on pain and quality of life outcomes post-genicular nerve block. The present study explores gait parameters using a novel approach not addressed earlier.
