Evidence map›Paper›PMID 36129904›Full record

SynthesisPloS one2022

Effects of neuromuscular gait modification strategies on indicators of knee joint load in people with medial knee osteoarthritis: A systematic review and meta-analysis.

M Denika C Silva, Diana M Perriman, Angela M Fearon, Daniel Tait, Trevor J Spencer, Dianne Walton-Sonda, Milena Simic, Rana S Hinman, Kim L Bennell, Jennie M Scarvell

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
2.2field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 15 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 2 countries.

M Denika C SilvaFaculty of Health, University of Canberra, Bruce, Australia.ORCID 0000-0001-8648-471X
Diana M PerrimanFaculty of Health, University of Canberra, Bruce, Australia.
Angela M FearonFaculty of Health, University of Canberra, Bruce, Australia.ORCID 0000-0001-5055-3074
Daniel TaitFaculty of Health, University of Canberra, Bruce, Australia.
Trevor J SpencerFaculty of Health, University of Canberra, Bruce, Australia.ORCID 0000-0002-1532-728X
Dianne Walton-SondaLibrary and Multimedia Services, Canberra Hospital, Canberra, Australia.
Milena SimicFaculty of Medicine and Health, The University of Sydney, Sydney, Australia.
Rana S HinmanCentre for Health, Exercise & Sports Medicine, Department of Physiotherapy, School of Health Sciences, University of Melbourne, Melbourne, Australia.
Kim L BennellCentre for Health, Exercise & Sports Medicine, Department of Physiotherapy, School of Health Sciences, University of Melbourne, Melbourne, Australia.
Jennie M ScarvellFaculty of Health, University of Canberra, Bruce, Australia.
University of Canberra · AUThe University of Melbourne · AUAustralian National University · AUCanberra Hospital · AUThe University of Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThis systematic review aimed to determine the effects of neuromuscular gait modification strategies on indicators of medial knee joint load in people with medial knee osteoarthritis.

methodsDatabases (Embase, MEDLINE, Cochrane Central, CINAHL and PubMed) were searched for studies of gait interventions aimed at reducing medial knee joint load indicators for adults with medial knee osteoarthritis. Studies evaluating gait aids or orthoses were excluded. Hedges' g effect sizes (ES) before and after gait retraining were estimated for inclusion in quality-adjusted meta-analysis models. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

resultsSeventeen studies (k = 17; n = 362) included two randomised placebo-controlled trials (RCT), four randomised cross-over trials, two case studies and nine cohort studies. The studies consisted of gait strategies of ipsilateral trunk lean (k = 4, n = 73), toe-out (k = 6, n = 104), toe-in (k = 5, n = 89), medial knee thrust (k = 3, n = 61), medial weight transfer at the foot (k = 1, n = 10), wider steps (k = 1, n = 15) and external knee adduction moment (KAM) biofeedback (k = 3, n = 84). Meta-analyses found that ipsilateral trunk lean reduced early stance peak KAM (KAM1, ES and 95%CI: -0.67, -1.01 to -0.33) with a dose-response effect and reduced KAM impulse (-0.37, -0.70 to -0.04) immediately after single-session training. Toe-out had no effect on KAM1 but reduced late stance peak KAM (KAM2; -0.42, -0.73 to -0.11) immediately post-training for single-session, 10 or 16-week interventions. Toe-in reduced KAM1 (-0.51, -0.81 to -0.20) and increased KAM2 (0.44, 0.04 to 0.85) immediately post-training for single-session to 6-week interventions. Visual, verbal and haptic feedback was used to train gait strategies. Certainty of evidence was very-low to low according to the GRADE approach.

conclusionVery-low to low certainty of evidence suggests that there is a potential that ipsilateral trunk lean, toe-out, and toe-in to be clinically helpful to reduce indicators of medial knee joint load. There is yet little evidence for interventions over several weeks.

Indexed as

Osteoarthritis, KneeAdultBiomechanical PhenomenaFootGaitHumansKnee Joint

Identifiers

PMID36129904
PMCPMC9491578
OpenAlexW4296793732

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.