- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04323969
Gait Modification for Knee Osteoarthritis (SENSMOD)
October 15, 2020 updated by: Michael Hunt, University of British Columbia
Foot Progression Angle Modification: an Exploratory Six-week Intervention in People With Knee Osteoarthritis
This randomized clinical trial will compare the changes in performance, biomechanical and clinical outcomes before and after a six-week gait modification intervention.
Participants with knee osteoarthritis will attend in-lab assessments and practice, while also performing daily, at-home walking tracked using a custom sensorized shoe.
Study Overview
Status
Terminated
Conditions
Intervention / Treatment
Detailed Description
Greater toe-in or toe-out angles during walking are potential biomechanical management strategies for medial compartment knee osteoarthritis (OA).
Multi-week clinical trials demonstrate the biomechanical efficacy and potential clinical efficacy.
However, walking biomechanics have only been assessed within laboratory environments and performance of the modifications during daily at-home walking is currently unknown.
Furthermore, the modifications have largely been instructed using a specific target, requiring motor learning.
No study has examined whether a self-directed strategy is feasible and will produce significant improvements in biomechanical and clinical outcomes.
Moreover, objective real-world performance of these modifications is unknown and may explain the previous inconsistent clinical results.
This study will address these gaps.
The investigators hypothesize that real-world performance of the modifications will improve over the intervention and that both groups will exhibit improvements in biomechanical and clinical outcomes at follow up.
Study Type
Interventional
Enrollment (Actual)
3
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
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British Columbia
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Vancouver, British Columbia, Canada, V6T 1Z3
- Motion Analysis and Biofeedback Laboratory
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
50 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Be 50 years of age or greater
- Exhibit signs of tibiofemoral OA (a score of ≥ 2 on the Kellgren and Lawrence (KL) grading scale) predominantly in the medial compartment,
- Self-reported knee pain ≥ 3 / 10 on a numerical rating scale of pain (NRS; 0 = "no pain" and 10 = "worst pain imaginable") during most days of the previous month
- Are comfortable walking intermittently for 30 minutes
- Fit into the available sizes of sensorized shoes (sizes spanning US women's 5 to men's 13)
- Exhibit at least a 5% reduction in knee adduction moment impulse for 10 degrees of change to foot rotation measured during a screening appointment.
Exclusion Criteria:
- Any knee surgery or intraarticular injections within the past 6 months
- A history of joint replacement surgery or high tibial osteotomy
- Current or recent (within 6 weeks) corticosteroid injections
- Use of a gait aid
- Currently on a wait list for joint replacement surgery or high tibial osteotomy
- Any inflammatory arthritic condition
- Any other conditions that may affect normal gait or participation in an aerobic exercise program
- Cannot attend all required appointments.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Specific Modification Target
A 15 degree relative increase to foot progression angle
|
Participants will be instructed to increase their baseline foot progression angle by 15 degrees.
Visual feedback during practice will be delivered using a mirror and guideline (tape placed on mirror).
Verbal feedback will be incorporated to encourage participants to perform the modified foot progression angle as accurately as possible.
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Experimental: Self-directed Modification
A self-directed increase to foot progression angle that is "as much as is comfortable".
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Participants will be instructed to modify their foot progression angle as much as is comfortable.
A mirror will be used during practice for visual feedback, but no specific target or guide will be provided.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in baseline to week 7 foot rotation angle error during stance - in lab walking
Time Frame: Baseline, Week 7
|
Foot rotation is the specific walking parameter that will be modified during the intervention.
It is defined as the angle between the long axis of the foot (heel to toe) and the walking direction.
Foot rotation will be measured via standard marker-based motion capture and sensor-based motion capture during baseline, follow up, and each practice session.
|
Baseline, Week 7
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Weekly change in baseline foot rotation angle error during stance - at home walking and during practice sessions
Time Frame: Baseline, Weeks 1, 2, 3, 4, 5, 6, 7
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Foot rotation is the specific walking parameter that will be modified during the intervention.
It is defined as the angle between the long axis of the foot and the walking direction.
Foot rotation will be measured via sensor-based motion capture over each week of the intervention.
Median and inter-quartile ranges will be taken as the primary summary statistic.
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Baseline, Weeks 1, 2, 3, 4, 5, 6, 7
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in baseline to week 7 knee joint moment impulse
Time Frame: Baseline, Week 7
|
Knee flexion and adduction moment impulses will be calculated.
Participants will walk on an instrumented walkway (2 force platforms) while 14 high speed cameras track the trajectories of markers placed on boney landmarks.
Moments will be calculated using an inverse dynamics approach.
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Baseline, Week 7
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Change in baseline to week 7 Knee Injury and Osteoarthritis Outcome Score (KOOS)
Time Frame: Baseline, Week 7
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Validated questionnaire on symptoms and functional limitations related to knee osteoarthritis.
The score is expressed in percentage (0-100), with 0 representing extreme knee problems and 100 representing no knee problems.
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Baseline, Week 7
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Change in baseline to week 7 knee pain on a numerical rating scale
Time Frame: Baseline, Week 7
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Knee pain rated on a 0 to 10 scale.
0 = "no pain at all" and 10 = "worst pain imaginable".
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Baseline, Week 7
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Change in week 1 to week 7 difficulty performing the modification on a numerical rating scale
Time Frame: Week 1, 7
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Difficulty will be rated on a 0 to 10 scale.
0 = "no difficulty at all" and 10 = "most difficulty imaginable".
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Week 1, 7
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Michael Hunt, PT, PhD, University of British Columbia
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
February 20, 2020
Primary Completion (Actual)
March 12, 2020
Study Completion (Actual)
March 12, 2020
Study Registration Dates
First Submitted
February 3, 2020
First Submitted That Met QC Criteria
March 25, 2020
First Posted (Actual)
March 27, 2020
Study Record Updates
Last Update Posted (Actual)
October 19, 2020
Last Update Submitted That Met QC Criteria
October 15, 2020
Last Verified
October 1, 2020
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- H19-02621
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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