Walking Aids in the Management of Hip Osteoarthritis

Osteoarthritis (OA), the most common joint disease in humans, is a significant cause of pain and disability. Non-pharmacological treatments for hip OA include education, exercise, appliances (walking sticks or insoles), and weight reduction if obese or overweight. Canes are often recommended to reduce adverse forces across joints although there is currently no research evidence regarding the efficacy of walking sticks for hip OA. Little information is available regarding the impact of walking aids on psychosocial function and quality of life in individuals with hip OA. This study will evaluate the effects of walking aids in hip OA by examining gait biomechanics, quality of life, pain, and opinions regarding using a cane.

Comparisons: Compare gait biomechanics in people with symptomatic unilateral hip OA while walking with and without a cane at baseline and after 4 weeks of cane use. Compare gait biomechanics in people with symptomatic unilateral hip OA with and without a cane to those of healthy, age-matched controls. Compare pain and health-related quality of life in people with symptomatic unilateral hip OA following 4 weeks of cane use. Determine the association between changes in gait biomechanics, pain, and health-related quality of life in people with symptomatic unilateral hip OA following 4 weeks of cane use.

Inclusion criteria

• hip OA (grades II-IV) of the Kellgren/Lawrence classification
• with pain in one hip for most days of the prior month
• Ability to walk 30 feet without postural sway
• Ability to stand unaided
• Ability to understand verbal instructions
• Ability to give informed consent

Exclusion criteria

• History of hip or knee trauma or surgery including arthroscopic surgery in the past six months
• Severe obesity (> 300 pounds)
• Neurological disorders that affect lower extremity function such as stroke or peripheral neuropathy, vestibular dysfunction or poor vision
• Injury or amputation to the lower extremity joints
• History of other types of arthritis or fibromyalgia
• Pain from spine, knee, ankle, or foot disease that would interfere with assessment of the hip
• Poor health that would impair compliance or assessment such as shortness of breath with exertion, chest pain
• Foot deformities such as hallux rigidus, valgus deformity of the midfoot, previous ankle arthrodesis
• Greater trochanteric pain syndrome