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Effects of Contralateral Versus Ipsilateral Cane Use on Gait in People with Knee Osteoarthritis
Author(s) -
Fang Meika A.,
Heiney Constance,
Yentes Jennifer M.,
Harada Nancy D.,
Masih Sulabha,
PerellGerson Karen L.
Publication year - 2015
Publication title -
pmandr
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.617
H-Index - 66
eISSN - 1934-1563
pISSN - 1934-1482
DOI - 10.1016/j.pmrj.2014.09.018
Subject(s) - cane , gait , medicine , ground reaction force , osteoarthritis , cadence , physical medicine and rehabilitation , physical therapy , force platform , gait analysis , kinematics , biochemistry , chemistry , physics , alternative medicine , sugar , classical mechanics , pathology
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.