Unintended Changes in Contralateral Limb as a Result of Acute Gait Modification.

Abstract

Gait modification using real-time biofeedback is a conservative intervention associated with positive outcomes. Results from systematic reviews corroborate the effectiveness of various strategies employing real-time biofeedback for reducing estimated knee joint load. The effects on the nonmodified limb, however, remain unclear. Biomechanical changes to the nonmodified limb were investigated during unilaterally implemented medial knee thrust, lateral trunk lean, and toe-in foot progression. Nineteen healthy participants were recruited. Ten trials were completed for each gait condition including baseline. Assigned magnitude for each gait modification strategy was individualized based on the mean and SD of the gait parameter during baseline. Visual real-time biofeedback was provided. During medial knee thrust, participants' nonmodified limb presented with increased: first peak medial knee contact force, internal first peak knee extensor moment, as well as knee- and hip-flexion angles at internal first peak knee extensor moment. Observed biomechanical changes are elucidative of the body's attempt to attenuate increased external loads. These findings may carry significant implications for pathological populations. Load redistribution to the nonmodified side may result in unfavorable long-term outcomes particularly in patients with bilateral diagnosis. Future studies should explore acute and chronic changes in the nonmodified limb of individuals with knee osteoarthritis.