Walk Smarter, Not Harder: Effects of Cadence Manipulation on Gait Biomechanics in Patients with Patellofemoral Osteoarthritis

Med Sci Sports Exerc. 2023 Apr 1;55(4):633-641. doi: 10.1249/MSS.0000000000003081. Epub 2022 Nov 7.

Abstract

Purpose: This study aimed to investigate the effect of walking cadence on knee flexion angular impulse and peak external flexion moment in patients with patellofemoral osteoarthritis (OA).

Methods: Forty-eight patients with patellofemoral OA underwent repeated quantitative gait analyses on an instrumented treadmill using a randomized crossover design. Walking trials were conducted at a fixed gait speed, under three cadence conditions: (i) preferred cadence, (ii) +10% increased cadence, and (iii) -10% decreased cadence, completed in random order. Using a linear mixed model, we tested the association of cadence conditions with surrogate measures of patellofemoral load (primary outcome measure: knee flexion angular impulse) while controlling for body mass. We then repeated the analyses while sequentially replacing the dependent variable with secondary outcome measures.

Results: Walking with increased cadence decreased (adjusted mean difference [95% confidence interval]) the knee flexion angular impulse (-0.85 N·m·s -1 [-1.52 to -0.18], d = 0.20) and peak knee flexion moment (-4.11 N·m [-7.35 to -0.86], d = 0.24), whereas walking with decreased cadence increased the knee flexion angular impulse (1.83 N·m·s -1 [1.15 to 2.49], d = 0.42) and peak knee flexion moment (3.55 N·m [0.30 to 6.78], d = 0.21). Similar decreases and increases were observed for secondary outcome measures.

Conclusions: Walking with increased cadence, while maintaining a fixed gait speed, reduces knee flexion angular impulse as well as other surrogate measures of knee loading in patients with patellofemoral OA.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomechanical Phenomena
  • Gait*
  • Humans
  • Knee Joint
  • Osteoarthritis, Knee*
  • Walking

Grants and funding