Walking Aids in the Management of Knee Osteoarthritis

• 1.Determine whether using the cane will improve functional outcome and health-related quality of life
• 2. Determine the reliability and validity of the Cane Use Cognitive Mediator Instrument and the Psychosocial Impact of Assistive Devices Scale
• 3.Define the factors associated with possession and use of walking aid for knee OA

The purpose of this study is to assess whether the single point cane will relieve pain and disability in overweight or obese people with knee OA through altered joint biomechanics and what factors influence acceptance of cane use.

Knee OA is an important cause of disability and falls in overweight or obese individuals and limits their attempts at exercise and subsequent weight loss. Walking aids such as canes have been recommended in the management of knee OA in order to decrease pain by reducing loading across the knee and to increase physical activity. Little information is available regarding the impact of walking aids on psychosocial function and quality of life in individuals with limited mobility. No randomized controlled trials have studied the efficacy of walking aids on quality of life, pain, and function in overweight or obese individuals with symptomatic knee OA (5,6). The proposed research will evaluate the effects of walking aids in knee OA by testing the following hypothesis that the use of a single-point cane will decrease pain from knee OA by altering gait biomechanics and will improve walking function and quality of life in overweight or obese individuals with symptomatic knee OA.

• Obesity
• Osteoarthritis

Inclusion Criteria:

1. 45-85 years old
2. Able to walk 30 feet without postural sway and able to stand unaided
3. Unilateral knee pain on movement with a WOMAC pain subscale of >35mm
4. Documented osteoarthritis based on clinical and radiographic criteria
5. Body Mass Index (BMI) > 25.0 - 29.9
6. Ability to understand verbal and written instructions
7. Ability to give informed consent determined by assessment of cognitive status

Exclusion Criteria:

1. Concurrent medical/arthritic disease that could confound or interfere with evaluation of pain or efficacy. History of knee trauma or surgery, including arthroscopic surgery, in the past six months
2. Severe obesity (weight > 300lbs)
3. Upper body weakness
4. Injury or amputation of the lower extremity joints
5. History of other types of arthritis
6. Spine, foot, or hip pain of sufficient magnitude to interfere with the evaluation of the index joint.
7. Isolated patellofemoral disease manifested by primarily anterior knee pain in the absence of tibiofemoral radiographic finding.
8. History of significant collateral or anterior cruciate ligament or meniscal injury to the index joint requiring at least one week of non weight bearing (minor ligamentous injury prior to 6 months is not an exclusion).
9. Poor health that would impair compliance or assessment such as shortness of breath with exertion
10. Neurological disease including vestibular dysfunction, or impaired vision
11. Patient has a history of any illness that, in the opinion of the investigator, might confound the results of the study or pose additional risk to the patient.
12. Is unable to understand and complete the study questionnaires including visual analog scale (VAS) responses.
13. Is unable to understand the study procedures.
14. Investigator feels the patient is otherwise inappropriate for the study. The patient is participating in another clinical trial that would interfere with participation in this study
15. Investigator feels the patient is otherwise inappropriate for the study.
16. The patient is participating in another clinical trial that would interfere with participation in this study