Foot Position Adjustments May Alleviate Knee Osteoarthritis Symptoms

A recent study led by researchers from NYU Langone Health, Stanford University, and the University of Utah has revealed that minor alterations in walking technique could significantly reduce knee pain associated with osteoarthritis and potentially slow the condition's progression. Osteoarthritis is a degenerative joint disease characterized by the breakdown of cartilage, primarily affecting the knee.

The study involved 68 participants diagnosed with mild to moderate knee osteoarthritis. Researchers investigated the impact of adjusting foot positioning during walking, specifically angling the feet inward or outward, on joint stress and pain levels. Advanced MRI scans were utilized to assess the effectiveness of this approach.

Results indicated that participants who modified their foot angle experienced a slower degeneration of knee cartilage compared to those who maintained their natural foot position. Specifically, those who adjusted their gait reported a decrease in pain levels by 2.5 points on a 10-point scale--equivalent to the relief provided by over-the-counter pain medications. In contrast, those who walked without altering their foot position only achieved a marginal reduction of just over one point.

The lead author of the study, Valentina Mazzoli, Ph.D., emphasized the significance of these findings, suggesting that personalized gait training could be a noninvasive method to delay surgical interventions, such as knee replacement. Early knee replacements can often lead to a higher likelihood of subsequent surgeries.

The study highlights the prevalence of osteoarthritis, with approximately one in seven Americans affected by some form of the disease, particularly in the inner knee area. The condition is a leading cause of disability and is generally managed through pain relief medications, physical therapy, and surgical options in severe cases. Excessive loading on the knee joint has been recognized as a contributing factor to the disease's progression.

Previous research had not convincingly demonstrated that gait modifications could alleviate knee pain in osteoarthritis patients. Earlier trials either applied a standardized foot angle for all participants or lacked a control group, leading to inconclusive results. This new research is pioneering in its approach, showing that tailored foot positioning can effectively reduce symptoms and may slow cartilage deterioration.

Mazzoli further noted that this technique presents advantages over conventional pain relief medications, which do not address the underlying issues of osteoarthritis and may cause adverse effects with prolonged use.

The research involved a treadmill assessment where participants' walking patterns were analyzed using a computer program to simulate their movements and measure stress on the knee joint. The team then generated models of various foot positions and evaluated which angles yielded the most favorable results in terms of stress reduction.

Participants were divided into two groups: one received training to adopt their personalized foot angle, while the other continued walking naturally. Pain assessments and MRI scans were conducted at the start and one year after the intervention. The findings showed a 4% reduction in maximum loading on the knees for those who adjusted their gait, while those who did not saw an increase of over 3% in joint loading.

The researchers highlighted the importance of individualized treatment approaches for osteoarthritis, underscoring that advances in artificial intelligence could facilitate personalized gait assessments using smartphone technology in clinical settings.

Future research will focus on determining whether these AI tools can effectively identify the optimal walking methods for osteoarthritis patients, with plans to include individuals with obesity in upcoming studies.