Abstract
Background. Conservative treatment for osteoarthritis often involves educating the patient in
methods of decreasing the load transmitted through the diseased joint. The use of
a cane is one such method and the correct placement of the cane with respect to an
abnormal knee joint is crucial. The purpose of this study was to compare effects on
knee moments of force of contralateral versus ipsilateral cane usage in female subjects
with osteoarthritic knees.
Methods. A convenience sample of 14 subjects volunteered for this study. Subjects walked over
force platforms while ground reaction force and three-dimensional kinematic data were
captured using a Vicon 370 System. The subjects were tested walking: (a) unaided,
(b) with ipsilateral cane, and (c) with contralateral cane. Inverse dynamics were
employed to calculate temporal–spatial, kinematic and kinetic variables. Dependent
variables included hip and knee frontal plane and sagittal plane moments of force,
walking speed, cadence and stride length. Repeated measures ANOVA assessed differences
among walking conditions.
Findings. Subjects walked significantly faster in the unaided gait condition owing to a higher
cadence. Ipsilateral cane use resulted in significantly larger hip (versus contralateral
P = 0.018; versus unaided P = 0.036) and knee (versus contralateral P = 0.043; versus unaided P = 0.030) frontal plane peak moments during gait. Contralateral cane placement was associated
with the smallest peak knee abductor (P = <0.001) and flexor (P = <0.001) moments. Knee deformity (varus or valgus) did not have any significant effect
on any variable possibly due to small sample size.
Interpretation. The results suggest that as is the case for the hip contralateral cane placement
is the most efficacious for persons with knee osteoarthritis. In fact, no cane use
may be preferable to ipsilateral cane usage as the latter resulted in the highest
knee moments of force, a situation which may exacerbate pain and deformity.
Keywords
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Article info
Publication history
Published online: February 15, 2005
Accepted:
December 21,
2004
Received:
November 30,
2003
Identification
Copyright
© 2005 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
