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Untacted automated robotic upper-trunk- lower reciprocal locomotor training for knee osteoarthritis: a randomized controlled trial
Cha Y, Yoon H, Park C, You SJH
Journal of Back and Musculoskeletal Rehabilitation 2023;36(5):1101-1110
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Although millions of people with osteoarthritis (OA) have altered biomechanical alignment, movement, and knee joint pain during gait, there are no effective and sustainable interventions. To mitigate such impairments, we developed an untacted self-automated robotic and electromyography (EMG)-augmented upper-trunk-lower reciprocal locomotor training (SRGT) intervention. OBJECTIVE: To compare the effects of SRGT and conventional treadmill gait training (CTGT) on the medial knee joint space width (JSW), hip adduction moment (HAM), knee varus deformity, pain, and physical function in community-dwelling older adults with OA. METHODS: Older adults diagnosed with medial compartment knee OA (5 men, 35 women; mean age 78.50 +/- 9.10 years) were recruited and underwent either SRGT or CTGT, 30 min a day, 3 times a week, over a 4 week period. Outcome measurements included the JSW, HAM, knee varus angle (VA), and Western Ontario McMaster Universities osteoarthritis index (WOMAC). RESULTS: Analysis of covariance (ANCOVA) showed that SRGT ed to greater changes in medial knee JSW (p = 0.00001), HAM (p = 0.00001), VA (p = 0.00001), and WOMAC (p = 0.00001) scores. CONCLUSION: This study provides the first evidence for the long-term clinical and biomechanical effects of SRGT on JSW, knee joint kinematics, kinetics, and WOMAC scores in older adults with OA. Most importantly, self-automatic robotic gait training may be an alternative, effective, and sustainable treatment for the upper-trunk-lower reciprocal locomotor training in older adults with OA.

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