A Van Ginckel1, R S Hinman2, T V Wrigley3, D J Hunter4, C J Marshall5, J Duryea6, L Melo7, M Simic8, J Kasza9, S R Robbins10, J A Wallis11, K L Bennell12. 1. Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium; Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Parkville, Australia. Electronic address: Ans.VanGinckel@UGent.be. 2. Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Parkville, Australia. Electronic address: ranash@unimelb.edu.au. 3. Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Parkville, Australia. Electronic address: timw@unimelb.edu.au. 4. Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Parkville, Australia. Electronic address: david.hunter@sydney.edu.au. 5. Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Parkville, Australia. Electronic address: c.marshall@unimelb.edu.au. 6. Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA. Electronic address: jduryea@bwh.harvard.edu. 7. Institute of Bone and Joint Research, Kolling Institute, The University of Sydney, Sydney, Australia; Department of Rheumatology, Royal North Shore Hospital, St Leonards, Australia. Electronic address: luciano.melo@sydney.edu.au. 8. Discipline of Physiotherapy, Musculoskeletal Research Group, Faculty of Health Sciences, The University of Sydney, Sydney, Australia. Electronic address: milena.simic@sydney.edu.au. 9. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia. Electronic address: jessica.kasza@monash.edu. 10. Institute of Bone and Joint Research, Kolling Institute, The University of Sydney, Sydney, Australia; Department of Rheumatology, Royal North Shore Hospital, St Leonards, Australia. Electronic address: sarah.robbins@sydney.edu.au. 11. Department of Physical Therapy, Eastern Health. Department of Physical Therapy, La Trobe University, Melbourne, Australia. Electronic address: Jason.wallis@easternhealth.org.au. 12. Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Parkville, Australia. Electronic address: k.bennell@unimelb.edu.au.
Abstract
OBJECTIVE: To evaluate effects of daily cane use for 3 months on medial tibiofemoral bone marrow lesion (BML) volumes in people with medial tibiofemoral osteoarthritis (OA). DESIGN: In this randomized controlled trial (RCT), 79 participants with medial tibiofemoral OA were randomized to either a cane group (using a cane whenever walking) or control group (not using any gait aid) for 3 months. The cane group received a single training session by a physiotherapist, using a biofeedback cane to teach optimal technique and body weight support and motor learning principles to facilitate retention of learning. The primary outcome was change in total medial tibiofemoral BML volume (per unit bone volume) measured from magnetic resonance imaging (MRI) at 3 months. Secondary outcomes were BML volumes (per unit bone volume) of the medial tibia and femur, and patient-reported outcomes of overall knee pain, knee pain on walking, physical function, perceived global symptom changes and health-related quality of life. MRI analyses were performed by a blinded assessor. RESULTS: Seventy-eight participants (99%) completed the primary outcome. Mean (standard deviation) daily cane use was 2.3 (1.7) hours over 3 months. No evidence of between-group differences was found for change in total medial tibiofemoral BML volume (mean difference: -0.0010 (95% confidence intervals: -0.0022, 0.0003)). Most secondary outcomes showed minimal differences between groups. CONCLUSION: Daily use of a cane during walking for 3 months aiming to reduce knee joint loading did not change medial tibiofemoral BML volumes compared to no use of gait aids. CLINICAL TRIAL REGISTRATION: Australian New Zealand Clinical Trial Registry (ACTRN12614000909628).
RCT Entities:
OBJECTIVE: To evaluate effects of daily cane use for 3 months on medial tibiofemoral bone marrow lesion (BML) volumes in people with medial tibiofemoral osteoarthritis (OA). DESIGN: In this randomized controlled trial (RCT), 79 participants with medial tibiofemoral OA were randomized to either a cane group (using a cane whenever walking) or control group (not using any gait aid) for 3 months. The cane group received a single training session by a physiotherapist, using a biofeedback cane to teach optimal technique and body weight support and motor learning principles to facilitate retention of learning. The primary outcome was change in total medial tibiofemoral BML volume (per unit bone volume) measured from magnetic resonance imaging (MRI) at 3 months. Secondary outcomes were BML volumes (per unit bone volume) of the medial tibia and femur, and patient-reported outcomes of overall knee pain, knee pain on walking, physical function, perceived global symptom changes and health-related quality of life. MRI analyses were performed by a blinded assessor. RESULTS: Seventy-eight participants (99%) completed the primary outcome. Mean (standard deviation) daily cane use was 2.3 (1.7) hours over 3 months. No evidence of between-group differences was found for change in total medial tibiofemoral BML volume (mean difference: -0.0010 (95% confidence intervals: -0.0022, 0.0003)). Most secondary outcomes showed minimal differences between groups. CONCLUSION: Daily use of a cane during walking for 3 months aiming to reduce knee joint loading did not change medial tibiofemoral BML volumes compared to no use of gait aids. CLINICAL TRIAL REGISTRATION: Australian New Zealand Clinical Trial Registry (ACTRN12614000909628).
Authors: Evan Schuster; Rebecca L Routson; Mason Hinchcliff; Karley Benoff; Pradeep Suri; Chris Richburg; Brittney C Muir; Joseph M Czerniecki; Patrick M Aubin Journal: J Biomech Date: 2020-11-28 Impact factor: 2.789