Walking Alteration for Knee osteoarthritis, the WALK study. An RCT*

Osteoarthritis (OA) of the knee is associated with changes in gait pattern.
These changes result in a dysfunctional gait pattern, that by itself can worsen
the OA symptoms. Main goal of the Walking ALteration for Knee osteoarthritis
(WALK) gait correction program is to achieve full passive and active knee
extension. This is a prerequisite for quadriceps relaxation in early mid stance
in the gait cycle, thus reducing the tibiofemoral forces during a considerate
period of the gait cycle. Our hypothesis is that adaptation of the gait pattern
through gait retraining can relieve the symptoms in knee OA.

To evaluate the effectiveness of the WALK gait retraining program, compared to
a standardised treatment protocol based on the KNGF (royal Dutch association of
physiotherapists) guidelines, in patients with clinical symptoms of mild to
moderate knee OA and a knee extension deficit. The hypothesis is that the WALK
gait retaining program is more effective to treat patients with symptoms of
mild to moderate knee OA (superiority study).

Open-labeled randomized controlled trial.

Patients will be randomized in a) WALK gait retraining program or in b)
physiotherapy with a standardised treatment protocol, in accordance with the
Dutch guideline for physiotherapists on knee OA (usual care).

The WALK gait retraining program has been shown to have favourable effects on
OA symptoms in mild to moderate knee OA in the WALK study pilot. This RCT is
executed to compare this method to current physiotherapeutic intervention.
Participating subjects will not be exposed to any additional risks.

Besides the treatment, subjects will undergo limited testing procedures;
functional outcome is assessed with questionnaires, and measurements of gait
parameters are performed with video based gait analysis, using adhesive markers
on anatomical landmarks, and skin electrodes for surface EMG measurements.