Article

OBJECTIVE: To compare the immediate effects of contralateral versus ipsilateral
cane use on spatiotemporal gait parameters and peak vertical ground force in
overweight or obese adults with symptomatic knee osteoarthritis (OA). DESIGN:
Prospective observational study. SETTING: An academic tertiary Veterans Affairs
Healthcare Center. PARTICIPANTS: Thirty-eight overweight or obese subjects with
symptomatic knee OA who had not used a cane for the past 30 days. METHODS:
Spatiotemporal gait data were obtained with an optical motion capture system
while subjects walked without a cane, with a cane contralateral to the more
painful lower limb, or with a cane ipsilateral to the more painful lower limb at
self-selected speeds. An in-shoe dynamic pressure distribution system was used to
measure the vertical ground reaction force. MAIN OUTCOME MEASUREMENTS:
Spatiotemporal measures of gait and peak vertical ground reaction force on both
lower limbs were recorded for each walking condition: no cane, contralateral
cane, and ipsilateral cane. RESULTS: Walking with a cane either contralateral or
ipsilateral to the more symptomatic limb led to significant reductions in gait
velocity (14%-16%), cadence (12%-14%), and peak vertical ground reaction force
(normalized for body weight; 11%-12%) on the more painful lower limb compared
with walking unaided (P < .05). There were no significant differences in the peak
vertical ground reaction force on either lower limbs when comparing walking with
a cane contralateral to the more painful limb or walking with a cane ipsilateral
to the more painful limb. Subjects also experienced a significant decrease in
gait velocity with contralateral or ipsilateral cane use compared with walking
without a cane; the lower walking speed was due to a decrease in cadence.
CONCLUSIONS: These results support the prescription of a single-point cane to
offload a lower limb with painful knee OA by holding the cane either ipsilateral
or contralateral to the more painful lower limb.
CI - Copyright (c) 2015 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS