Ischemic preconditioning alters gait mechanics in older adults with knee osteoarthritis.

Abstract

Individuals with knee osteoarthritis exhibit altered gait mechanics. While physical activity is recommended as a first-line treatment, few interventions outside of exercise have demonstrated significant gait changes. This study evaluated changes in gait mechanics after a single session of ischemic preconditioning in participants with knee osteoarthritis. Thirty-one participants with knee osteoarthritis over the age of 50 completed gait analysis before and after a single session of ischemic preconditioning(n = 15) or sham(n = 16). The treatment consisted of 5-min of inflation (225 mmHg for IC; 25 mmHg for sham) and 5-min of reperfusion for 50-min. Ankle, knee, hip, and trunk triplanar kinematics, kinetics, and ground reaction forces were analyzed bilaterally. Data were reduced to 0-100% of gait cycle (kinematics) or stance phase (kinetics). Change scores were calculated for each 1% of gait cycle with 90% confidence intervals, and mean differences were calculated for significant differences. After ischemic preconditioning, participants demonstrated reduced knee valgus(2.42 ± 0.11°), knee external rotation(4.29 ± 0.22°), trunk rotation moment (0.02 ± 0.001 Nm/kg), and increased trunk lateral flexion(2.32 ± 0.07°) towards the involved side, and trunk extension moment(0.19 ± 0.005 Nm/kg) in the involved limb compared to sham. Participants demonstrated increased hip external rotation moment(0.06 ± 0.01 Nm/kg) and trunk rotation moment(0.03 ± 0.002 Nm/kg) and reduced vertical ground reaction force(0.25 ± 0.04 N/kg) after ischemic preconditioning in the uninvolved limb compared to sham group. A single session of ischemic preconditioning alters gait mechanics acutely in both limbs. Ischemic preconditioning is a novel, passive treatment that can potentially aid in modifying gait in knee osteoarthritis.