Arthritis & Rheumatism, Volume 60,
October 2009 Abstract Supplement
The 2009 ACR/ARHP Annual Scientific Meeting
Philadelphia October 16-21, 2009.
Effect of Cane Use On Lower Limb Biomechanics and Pain in Knee Osteoarthritis
Lee1, Sarah M., Heiney2, Constance, Perell3, Karen L., Masih2, Sulabha, Harada2, Nancy D., Yentes2, Jennifer M., Fang2, Meika A.
Dynamic loading of the medial knee is associated with progression of knee osteoarthritis (OA). Therefore interventions that lessen the load of the medial knee may minimize the risk of disease progression. Previous studies have shown that walking with a cane has an immediate effect of reducing the peak knee adduction moment and peak vertical force in people with knee OA. The objective of the current study is to determine whether short-term cane use will lead to persistent alterations in gait biomechanics and improve pain and physical activity in individuals with painful knee osteoarthritis.
Twenty-one overweight or obese participants with symptomatic knee OA were given a single point cane to use contra-lateral to the painful limb for eight weeks. All participants underwent gait assessment with and without a cane at baseline and at 8 weeks by using a three-dimensional motion capture system and an in-shoe dynamic pressure distribution system. The peak vertical force and mean lateral deviation of the center of pressure (COP) of the painful limb were measured. OA-related pain was assessed with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and physical activity level was measured with the Physical Activity Scale for Elderly (PASE).
Twenty-one participants (mean age 62.6 ± 7.9 years, male) completed the study. Cane users who used the cane frequently (>= 4 days per week) had greater pain at baseline than those who used the cane less frequently and 50% of the frequent cane users demonstrated a 20% or greater decrease in pain. The frequent cane users also had a 22% increase in the mean lateral deviation of COP for the painful limb when walking with a cane compared to walking unaided during the baseline visit (P=0.002). After 8 weeks of walking with a cane, the frequent cane users maintained this increase in mean lateral COP deviation when walking with and without a cane. Peak vertical force decreased 11.9% on the painful limb with cane use after eight weeks of walking with a cane. There were no significant changes in physical activity level as measured with the PASE.
To our knowledge, this is the first study to demonstrate that frequent cane use in people with painful knee OA display an immediate lateral shift in the center of pressure; this effect is maintained in frequent cane users after walking with a cane for 8 weeks. Furthermore, we show that frequent cane use may reduce pain and decrease peak vertical force in the painful limb. These findings suggest that regular cane use may be potential cost-effective and noninvasive interventions for knee OA by unloading the medial compartment of the knee and decreasing pain.
To cite this abstract, please use the following information:
Lee, Sarah M., Heiney, Constance, Perell, Karen L., Masih, Sulabha, Harada, Nancy D., Yentes, Jennifer M., et al; Effect of Cane Use On Lower Limb Biomechanics and Pain in Knee Osteoarthritis [abstract]. Arthritis Rheum 2009;60 Suppl 10 :830