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Impact of Osteopathic Manipulative Treatment on Chronic Persistent Gait Dysfunction Following Total Knee Arthroplasty

Journal: The AAO Journal Date: 2022/06, 32(2):Pages: 30. doi: Subito , type of study: clinical trial

Free full text   (https://meridian.allenpress.com/aaoj/article/32/2/15/482674/LBORC-NUFA-Poster-Abstracts-2022-Students)

Keywords:

chronic persistent gait dysfunction [1]
clinical trial [612]
knee arthroplasty [4]
OMT [2951]
osteopathic manipulative treatment [2973]

Abstract:

Introduction/Background: Musculoskeletal compensations before/after Total Knee Arthroplasty (TKA) may contribute to knee pain, reduced range of motion, and altered gait mechanics. Gait analysis provides a quantitative and functional outcome measure for the efficacy of Osteopathic Manipulative Treatment (OMT) on TKA rehabilitation. Objective: Provide accurate and quantitative temporal and spatial assessment for the efficacy of OMT on gait dysfunction. Hypothesis: OMT will improve symmetry of spatiotemporal kinetics, and kinematic parameters of gait between operative and non-operative limbs. Methods: IRB approval was obtained (MWU#21053) and subjects with unilateral TKA were recruited. Subjects were assessed for quadriceps strength, leg length, knee range of motion, and knee pain/functional limitations (KOS-ADL). An 8-camera motion-capture system and force plates acquired kinetic and kinematic data of walking gait. Somatic dysfunction was assessed and treated by an Osteopathic physician (30min); and gait analysis repeated. Data were tabulated with SPSS software with significance equal p<0.05. Results: (N=2) Improvements in KOS-ADL and quadriceps strength in the operative limb (+4.7lbs and +26.4lbs, respectively) were observed following OMT. Walking speed and cadence increased in both subjects. Notably, OMT increased anterior pelvic tilt with a corresponding increase in internal hip rotation and peak knee extension in the stance phase (3.7° to 0.1° of knee flexion, Subject 1); and increased pelvic obliquity during the stance phase (–1.8 to –3.9°, Subject 2). Conclusion/Discussion: A single session of OMT led to improved kinematic changes in gait and functional outcome measures. The utility of gait analysis is linking somatic dysfunction to specific spatiotemporal, kinetic and kinematic parameters that are improved with OMT. Study limitation: small sample size. Future studies will assess whether chronic gait dysfunction can be improved with weekly OMT.


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