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NCT Number: NCT06208631

Effects of Movement Retraining on Knee Loading in Individuals With Knee Osteoarthritis

This study investigates how well individuals with knee osteoarthritis can learn to alter their calf muscle activation using haptic biofeedback while walking and evaluates how these changes affect knee loading.

Prior research has utilized musculoskeletal simulations to determine that reducing the activation of one of the calf muscles, the gastrocnemius, can have a large impact on reducing knee loading. However, this has not been tested in individuals with knee osteoarthritis. In this study, participants will be trained to alter the activation of their gastrocnemius muscle, by receiving haptic feedback after each step. The feedback will indicate how the participant changed their muscle activation relative to baseline. Some participants will train on a treadmill in the laboratory for up to two sessions, with 30 minutes of walking with feedback in each session. If a participant can learn to adjust their muscle activation in the first training session, they will be able to complete the second training session. Other participants will train outside the laboratory for one session with 30 minutes of walking with feedback to investigate changes in knee loading while using the new walking strategy during over-ground walking.

The movement data collected during the training sessions will be used as inputs to computer simulations of the musculoskeletal system to determine if walking with the new muscle activation strategy reduces knee loading.

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Key information

Conditions

Osteoarthritis, Knee Arthritis Joint Diseases Musculoskeletal Diseases Osteoarthritis Rheumatic Diseases

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Stanford Human Performance Lab

Stanford, California, 94305, United States

Location status: Recruiting

Location contact

Scott D Uhlrich, PhD

CONTACT

[email protected]

650-721-2547

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Medial and/or lateral compartment knee osteoarthritis
  • Diagnosed with knee osteoarthritis of at least six months duration
  • Ambulatory without aids
  • Able to walk for at least 60 minutes
  • Typical pain rating of 1-4 on scale of 0-10
  • Able to reduce gastrocnemius muscle activation by 10% from baseline

Exclusion criteria

  • History of symptomatic arthritis in lower limb joints other than the knees
  • Replacement of any lower extremity joint
  • Symptoms originating from the patellofemoral joint
  • Body mass index equal to or greater than 35
  • Nerve or muscle disease associated with walking difficulty
  • History of rheumatoid arthritis, gout, or autoimmune disease
  • History of lower limb fracture or surgery requiring hospitalization
  • Pregnant

Treatment and study plan

Gait Retraining

Behavioral

Changing muscle coordination while walking

Primary outcomes

  1. Change from baseline in knee contact force

    Time frame: Evaluated during the 30 minutes of feedback walking in the second in-lab session and out-of-lab session

    Knee contact force will be evaluated using motion capture data and musculoskeletal modeling and simulations, for participants that are able to reduce gastrocnemius activation.

Secondary outcomes

  1. Change from baseline in gastrocnemius activation

    Time frame: Evaluated during the 30 minutes of feedback walking in the first in-lab session, the second in-lab session, and the out-of-lab session

    Gastrocnemius activation measured through EMG signals.

  2. Proportion of participants that reduce gastrocnemius activation

    Time frame: Evaluated during the 30 minutes of feedback walking in the first in-lab session, the second in-lab session, and the out-of-lab session

    Gastrocnemius activation will be measured through electromyography (EMG) signals, and the muscle activation during gait retraining will be compared to baseline walking. Participants that can reduce gastrocnemius activation 10% or more from baseline within 30 minutes of gait retraining will be counted as participants that can reduce gastrocnemius activation out of the total number of participants who try the gait retraining.

  3. Proportion of participants that reduce knee contact force

    Time frame: Evaluated during the 30 minutes of feedback walking in the second in-lab session and the out-of-lab session

    For the participants who can successfully reduce gastrocnemius activation from baseline, knee contact force will be calculated using motion capture data and musculoskeletal modeling and simulations. The proportion of participants that reduce knee contact force from baseline during gait retraining out of the total participants that reduce gastrocnemius activation will be evaluated.

Study contacts

Contact information is provided by the study sponsor or research team.

Study Team

CONTACT

[email protected]

650-721-2547

Sponsors and collaborators

Lead sponsor

Stanford University

Other

Registry information

Official study title

Effects of Haptic Movement Retraining on Osteoarthritis Progression

Important dates

Study start
2024
Primary completion
2026
Study completion
2026
First posted
Jan 17, 2024
Registry last updated
Jun 23, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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