Gait Retraining for Knee Osteoarthritis

Overseen By Michael A Hunt, PT, PhD

Age: 18+

Sex: Female

Trial Phase: Academic

Sponsor: University of British Columbia

Must not be taking: Corticosteroids, Viscosupplementation, NSAIDs, Analgesics

Disqualifiers: Traumatic knee injury, Neurological, Cardiovascular, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

Duration: 4 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if altering running techniques can reduce knee pain and improve movement for individuals with knee osteoarthritis. It focuses on teaching runners new movement methods (gait retraining) to ease symptoms and reduce knee stress. Individuals who have run at least 10 kilometers a week for the past six months and frequently experience knee pain may be suitable for this study. As an unphased trial, this study provides a unique opportunity to explore innovative methods for managing knee pain and enhancing the running experience.

Will I have to stop taking my current medications?

The trial excludes people who regularly use non-steroidal anti-inflammatory drugs, pain relievers, or knee braces before, during, or after running. If you use these regularly, you may not be eligible to participate.

What prior data suggests that this gait retraining is safe for runners with knee osteoarthritis?

Research shows that changing the way one walks or runs, known as gait retraining, might be safe for people with knee osteoarthritis. Studies have found that these changes can help reduce knee pain and lessen stress on the knee. One study found that personalized changes in walking style helped reduce pain and might slow the disease's progression. A review of various studies reported that exercise, including gait retraining, didn't show major safety concerns.

While complete safety information isn't always available, the evidence so far suggests that gait retraining is generally well-tolerated. For those considering joining a trial for this, current research looks promising regarding safety. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Gait retraining is unique because it focuses on modifying how individuals with knee osteoarthritis run, which is different from standard treatments like pain medications, physical therapy, or surgery. This method teaches runners to adjust their running technique through personalized sessions, potentially reducing joint stress and improving long-term joint health. Researchers are excited about this approach because it targets the root of the problem—biomechanics—offering a non-invasive alternative that could enhance mobility and quality of life without the side effects associated with drugs or the risks of surgery.

What evidence suggests that gait retraining is effective for knee osteoarthritis?

Research shows that changing the way people walk or run can help those with knee osteoarthritis. Studies have found that adjusting walking style can reduce knee pain and lessen stress on the knee joint. For example, one study discovered that changing walking patterns can slow cartilage damage and relieve pain as effectively as some medications. Another study found that altering the angle of the toes while walking or running is feasible and can reduce pain. These findings suggest that gait retraining, which participants in this trial will undergo, could be a promising way to manage symptoms for runners with knee osteoarthritis. ^{1 2 5 6 7}

Who Is on the Research Team?

Michael A Hunt, PT, PhD

Principal Investigator

University of British Columbia

Are You a Good Fit for This Trial?

This trial is for adult runners who have mild to moderate knee osteoarthritis, run at least 10 km weekly for over six months, can comfortably run on a treadmill for 30 minutes, and experience knee pain most days. It's not suitable for non-English speakers, those with recent serious knee injuries or certain medications, heart conditions that make running unsafe, or other leg issues affecting running.

Inclusion Criteria

I have experienced knee pain of at least 3 out of 10 nearly every day last month.

My arthritis is mild to moderate according to the Kellgren and Lawrence scale.

You have been consistently running for at least 6 months, covering a distance of 10 kilometers every week.

Exclusion Criteria

I haven't used any corticosteroids or viscosupplementation in the last 6 months.

I have heart or lung conditions that prevent me from safely doing moderate running.

I have a condition in my lower limb that affects my ability to run, not including TFOA.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo a 4-week running gait retraining program to modify their running gait

4 weeks

Multiple laboratory sessions and in-field training

Follow-up

Participants are monitored for changes in pain, function, and knee loading after the retraining program

4 months

Assessments at 2 weeks, 4 weeks, 2 months, 3 months, and 4 months

What Are the Treatments Tested in This Trial?

Interventions

• Gait retraining

Trial Overview

The study tests a 4-week program designed to change how people with knee osteoarthritis run (gait retraining). The goal is to see if these changes can reduce their symptoms like pain and improve their ability to function without putting too much stress on the knees.

How Is the Trial Designed?

Group I: Gait retraining Experimental Treatment 1 Intervention

Runners will be taught how to modify their running gait through multiple laboratory sessions and in-field training.

Who Is Running the Clinical Trial?

University of British Columbia

Lead Sponsor

Trials

1,506

Recruited

2,528,000+

Published Research Related to This Trial

Gait retraining significantly reduced the knee adduction moment (KAM) in patients with early knee osteoarthritis, with improvements maintained for up to 6 months after training, indicating its effectiveness as a therapeutic intervention.

Patients who underwent gait retraining also showed significant improvements in their symptoms as measured by the WOMAC osteoarthritis index, while those in the walking exercise group did not experience similar benefits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Immediate and short-term effects of gait retraining on the knee joint moments and symptoms in patients with early tibiofemoral joint osteoarthritis: a randomized controlled trial. Cheung, RTH., Ho, KKW., Au, IPH., et al.[2019]

A wearable visual feedback system using inertial measurement units was developed for gait retraining in patients with knee osteoarthritis, showing high accuracy (2.4 degrees RMS) in tracking foot progression angle compared to traditional optical motion capture systems.

The effectiveness of the wearable system in providing biofeedback was comparable to laboratory methods, achieving about 50% success in guiding participants to maintain the target foot progression angle, suggesting it could simplify and enhance clinical adoption of gait retraining interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Validation of wearable visual feedback for retraining foot progression angle using inertial sensors and an augmented reality headset. Karatsidis, A., Richards, RE., Konrath, JM., et al.[2019]

This study will evaluate the effectiveness of a six-week toe-in and toe-out gait retraining program on reducing knee joint load and varus thrust in 90 participants with medial knee osteoarthritis, comparing these interventions to a placebo.

The trial aims to assess not only the biomechanical outcomes but also improvements in pain, physical function, and quality of life, with follow-up assessments at three months to determine the sustainability of any benefits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Toe-in and toe-out gait retraining interventions to reduce proxy measures of medial knee joint load in people with medial knee osteoarthritis: Protocol for a randomised placebo-controlled trial. Hutchison, L., D'Souza, N., Grayson, J., et al.[2023]

This feasibility study involves 40 individuals with knee osteoarthritis and aims to assess the effectiveness of a gait retraining program compared to a traditional walking program, focusing on reducing knee pain and impact loading.

The study will evaluate treatment effects through established measures of knee pain and motion analysis, providing essential data to support a larger randomized controlled trial in the future.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Reducing knee pain and loading with a gait retraining program for individuals with knee osteoarthritis: Protocol for a randomized feasibility trial. Corrigan, P., Davis, IS., James, KA., et al.[2022]

Citations

1.

pubmed.ncbi.nlm.nih.gov

pubmed.ncbi.nlm.nih.gov/40816302/

Personalised gait retraining for medial compartment knee ...

Primary outcomes were 1-year changes in medial knee pain (numeric rating scale) and medial knee loading (knee adduction moment peak).

2.

thelancet.com

thelancet.com/journals/lanrhe/article/PIIS2665-9913(25)00151-1/abstract

Personalised gait retraining for medial compartment knee ...

This study investigated the clinical, biomechanical, and structural efficacy of personalised foot progression angle modifications compared with ...

3.

news.stanford.edu

news.stanford.edu/stories/2025/08/gait-retraining-knee-osteoarthritis-cartilage-damage-treatment-walking

Study reveals gait retraining could help treat knee osteoarthritis

New research demonstrates how personalized walking patterns can slow cartilage degradation and deliver pain relief comparable to medication.

4.

sciencedirect.com

sciencedirect.com/science/article/pii/S0268003324002080

Toe-in and toe-out gait retraining interventions for ...

Toe-in and toe-out gait retraining is feasible and improves pain in people with knee osteoarthritis. A full-scale randomised clinical trial is warranted.

5.

clinicaltrials.gov

clinicaltrials.gov/study/NCT02767570

Study Details | NCT02767570 | Long-Term Effectiveness of ...

This study is a randomized controlled trial to investigate conservative treatments for individuals with painful knee osteoarthritis (OA). The study will recruit ...

6.

bmj.com

bmj.com/content/391/bmj-2025-085242

systematic review and network meta-analysis

The safety outcome was reported in a small proportion of studies (40 studies, 18%), and no clear differences were observed between exercise ...

7.

sciencedirect.com

sciencedirect.com/science/article/pii/S004901722500126X

The effect of walking interventions on biomechanical knee ...

Walking interventions elicit minimal-to-no change in discrete biomechanical metrics of joint loading for individuals with mild-to-moderate knee osteoarthritis.