Article

OBJECTIVE: To review the current literature regarding methods and effects of
real-time biofeedback used as a method for gait retraining to reduce knee
adduction moment (KAM), with intended application for patients with knee osteoarthritis (KOA). DATA SOURCES: Searches were conducted in MEDLINE, Embase,
CINAHL, SPORTDiscus, Web of Science, and Cochrane Central Register of Controlled
Trials with the keywords gait, feedback, and knee osteoarthritis from inception
to May 2015. STUDY SELECTION: Titles and abstracts were screened by 1 individual
for studies aiming to reduce KAM. Full-text articles were assessed by 2
individuals against predefined criteria. DATA EXTRACTION: Data were extracted by
1 individual according to a predefined list, including participant demographics
and training methods and effects. DATA SYNTHESIS: Electronic searches resulted in
190 potentially eligible studies, from which 12 met all inclusion criteria.
Within-group standardized mean differences (SMDs) for reduction of KAM in healthy
controls ranged from .44 to 2.47 and from .29 to .37 in patients with KOA. In
patients with KOA, improvements were reported in pain and function, with SMDs
ranging from .55 to 1.16. Methods of implementation of biofeedback training
varied between studies, but in healthy controls increased KAM reduction was noted
with implicit, rather than explicit, instructions.
CONCLUSIONS: This review
suggests that biofeedback gait training is effective primarily for reducing KAM
but also for reducing pain and improving function in patients with KOA. The
review was limited by the small number of studies featuring patients with KOA and
the lack of controlled studies. The results suggest there is value and a need in
further researching biofeedback training for reducing KAM. Future studies should
include larger cohorts of patients, long-term follow-up, and controlled trials.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS