Six‐week gait retraining program reduces knee adduction moment, reduces pain, and improves function for individuals with medial compartment knee osteoarthritis

Dear Sir, We read with interest the article “Six-Week Gait Retraining Program Reduces Knee Adduction Moment, Reduces Pain, and Improves Function for Individuals with Medial Compartment Knee Osteoarthritis” by Shull et al. This is an important article that supports existing knowledge about the effect of non-invasive interventions, based on gait training, to establish new motor patterns for patients suffering from knee OA. The researchers examined the influence of a 6-week gait retraining program on the knee adduction moment (KAM), as well as knee pain and function, on 10 patients with medial compartment knee OA. Results demonstrated that following the 6-week program, the first peak KAM reduced by 20%, and WOMAC pain and function scores were improved by 29% and 32%, respectively. After reading this study, we would like to provide some additional information to the reader. The results of the current article support previous articles published by Erhart et al. in 2010 and by Haim et al. in 2012. The research methodology of all three articles was similar in that they examined the changes in KAM and WOMAC following intervention, and in all cases patients walked barefoot during examinations. Erhart et al. reported a 6.6% reduction in KAM for subjects with knee OA wearing variable-stiffness shoes for six months, whereas Haim et al. reported a 15.5% reduction in KAM, and an improvement of WOMAC pain and function by 61.0% and 63.0%, respectively. The importance of non-invasive biomechanical interventions, and their effect on biomechanical parameters (i.e., KAM) and clinical symptoms of pain and function has increased in the last decade. Only in the past few years it has been shown that, following training with a certain biomechanical device, the above-mentioned parameters improve while walking barefoot. Recently, Shakoor et al. evaluated the effects of 6 months of use of flat, flexible footwear (the mobility shoe) on knee loading in OA. Their findings support the results of previous publications, which showed a 10% reduction in KAM. The current article of Shull et al. and the studies of Erhart et al., Haim et al., and Shakoor et al., establish the realization of the effect of biomechanical interventions on biomechanical parameters and clinical symptoms. These articles should serve as the supporting pillar in this field and should further be examined. The next challenge should be to examine the longterm effect of these interventions on the disease’s progress.