70 Participants Needed

Gait Rehabilitation for Knee Osteoarthritis After ACL Injury

CA
BP
KC
NF
Overseen ByNatalia Favoreto, MS
Age: < 65
Sex: Any
Trial Phase: Academic
Sponsor: University of North Carolina, Chapel Hill
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Real-time gait biofeedback for knee osteoarthritis after ACL injury?

Research shows that biofeedback, which provides real-time sensory feedback, can improve gait rehabilitation outcomes by helping people adjust their walking patterns. This approach has been effective in improving gait mechanics after ACL reconstruction, which may suggest potential benefits for knee osteoarthritis rehabilitation as well.12345

Is real-time gait biofeedback safe for humans?

Research on real-time gait biofeedback, used for various conditions like knee hyperextension and chronic ankle instability, shows it is generally safe for humans. Studies have not reported any significant safety concerns, indicating it can be a safe method for gait retraining.16789

How does real-time gait biofeedback treatment differ from other treatments for knee osteoarthritis after ACL injury?

Real-time gait biofeedback is unique because it provides immediate feedback to patients on their walking patterns, helping them adjust their gait in real-time to reduce stress on the knee joint. This approach is noninvasive and uses visual or tactile cues to guide patients in modifying their movements, which can be more effective and efficient than traditional methods that rely on verbal instructions alone.2791011

What is the purpose of this trial?

The purpose of this study is to determine the effects of real-time gait biofeedback delivered over a 6-week period on early markers of FastOA and conduct 6-week and 6-month follow-up assessments in anterior cruciate ligament reconstructed patients.

Research Team

BP

Brian G Pietrosimone, PhD

Principal Investigator

University of North Carolina, Chapel Hill

Eligibility Criteria

This trial is for individuals aged 18-35 who have had ACL reconstruction surgery between 6 and 24 months ago, completed all physical therapy, walk with less force than usual (vGRF impact peak <1.09 x body weight), and have significant knee symptoms (KOOS-QOL <72). It's not for those with a BMI ≥36, knee osteoarthritis, history of lower extremity fractures, or multiple ligament surgeries.

Inclusion Criteria

I had ACL surgery between 6 months and 5 years ago.
I have finished all my prescribed physical therapy sessions.
I am between 16 and 35 years old.
See 2 more

Exclusion Criteria

My BMI is 36 or higher.
I have knee osteoarthritis.
I am scheduled for or have had ACL revision surgery.
See 2 more

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive real-time gait biofeedback or sham biofeedback over a 6-week period

6 weeks
Weekly sessions

Follow-up

Participants are monitored for safety and effectiveness after treatment with assessments at 6 weeks and 6 months

6 months
Assessments at 6 weeks and 6 months

Treatment Details

Interventions

  • Real-time gait biofeedback
  • Sham real-time gait biofeedback
Trial Overview The study tests the effects of real-time gait biofeedback over six weeks on early markers of FastOA in patients who've undergone ACL reconstruction. Participants will receive either actual biofeedback or sham feedback to compare outcomes at the end of treatment and after six months.
Participant Groups
2Treatment groups
Active Control
Placebo Group
Group I: Real-time gait biofeedback (RTGBF)Active Control1 Intervention
The RTGBF regimen delivers biofeedback that cues a personalized target to normalize vertical ground reaction force (vGRF) of each limb.
Group II: Sham real-time gait biofeedback (Sham RTGBF)Placebo Group1 Intervention
The Sham RTGBF regimen will receive biofeedback that cues their habitual step length determined during the accommodation period on the first session of treadmill walking.

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of North Carolina, Chapel Hill

Lead Sponsor

Trials
1,588
Recruited
4,364,000+

Arthritis Foundation

Collaborator

Trials
36
Recruited
46,500+

Findings from Research

A novel biofeedback intervention aimed at improving landing mechanics in 40 patients post-ACL reconstruction showed significant improvements in peak vertical ground reaction force symmetry after 12 sessions over six weeks, but these improvements were not maintained in the long term.
Despite the initial benefits in symmetry, the biofeedback program did not effectively reduce risk factors for subsequent ACL injuries, suggesting the need for further research into more comprehensive intervention strategies.
Reduction of risk factors for ACL Re-injuries using an innovative biofeedback approach: A phase I randomized clinical trial.Peebles, AT., Miller, TK., Savla, J., et al.[2023]
Gait retraining using the force-driven harmonic oscillator (FDHO) model significantly improved lower-extremity kinematics and kinetics in patients with ACL reconstruction, while the preferred stride frequency (PSF) protocol showed no improvements.
The FDHO protocol led to better recovery in knee range of motion and hip extensor function over a 6-week training period, indicating its effectiveness in enhancing gait patterns post-surgery.
Gait retraining after anterior cruciate ligament reconstruction.Decker, MJ., Torry, MR., Noonan, TJ., et al.[2022]
Biofeedback targeting lower extremity loading mechanics after anterior cruciate ligament reconstruction (ACLR) can significantly alter stride interval dynamics, which may help prevent post-traumatic osteoarthritis.
In a study with 12 participants, both high and low loading conditions led to more temporally persistent stride intervals compared to a control condition, suggesting that feedback can effectively influence gait strategies in individuals recovering from ACLR.
Biofeedback augmenting lower limb loading alters the underlying temporal structure of gait following anterior cruciate ligament reconstruction.Armitano-Lago, C., Pietrosimone, B., Davis-Wilson, HC., et al.[2022]

References

Reduction of risk factors for ACL Re-injuries using an innovative biofeedback approach: A phase I randomized clinical trial. [2023]
Gait retraining after anterior cruciate ligament reconstruction. [2022]
Biofeedback augmenting lower limb loading alters the underlying temporal structure of gait following anterior cruciate ligament reconstruction. [2022]
The Short-Term Effects of Rhythmic Vibrotactile and Auditory Biofeedback on the Gait of Individuals After Weight-Induced Asymmetry. [2023]
Comparison of mirror, raw video, and real-time visual biofeedback for training toe-out gait in individuals with knee osteoarthritis. [2014]
Short and long-term effects of gait retraining using real-time biofeedback to reduce knee hyperextension pattern in young women. [2018]
Biofeedback gait training system for temporal and distance factors. [2019]
Gait biofeedback and impairment-based rehabilitation for chronic ankle instability. [2021]
Gait Retraining With Real-Time Biofeedback to Reduce Knee Adduction Moment: Systematic Review of Effects and Methods Used. [2022]
10.United Statespubmed.ncbi.nlm.nih.gov
Real-time knee adduction moment feedback for gait retraining through visual and tactile displays. [2011]
11.United Statespubmed.ncbi.nlm.nih.gov
Biofeedback versus physiotherapy in patients with partial weight-bearing. [2022]
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