Comparison of Mirror, Raw Video, and Real-time Visual Biofeedback for Training Toe-out Gait in Individuals with Knee Osteoarthritis

The aim of this study was to compare performance error and perceived difficulty during toe-out gait modification in individuals with knee osteoarthritis (OA) across three different types of visual feedback: mirror, raw video, and real-time biofeedback of toe-out angle. Twenty individuals with knee OA (11 female; age = 65.4 +/- 9.8 years) took part in this study at a university motion analysis laboratory. Seven participants had mild knee OA, nine had moderate knee OA, and four had severe knee OA. Participants were trained to walk on a treadmill while matching a target indicating a ten degree increase in stance phase toe-out compared to toe-out angle measured during self-selected walking. The target was provided visually by way of the three types of feedback listed above and were presented in a random order. Kinematic data were collected and used to calculate the difference between the target angle and actual performed angle for each condition (toe-out performance error). Difficulty was assessed using a numerical rating scale (0-10) provided verbally by participants. Toe-out performance error was significantly lower when using the real-time biofeedback compared to the other two methods (p = 0.025; mean difference vs. mirror = 2.05°; mean difference vs. raw video = 1.51°). Perceived difficulty was not statistically different between the groups (p = 0.51).

Though statistically significant, the 2 degree differences in toe-out gait performance error may not mean that the large economic and personnel costs of real-time biofeedback as a means to modify movement in clinical or research settings are necessary.

The Knee Course

Having a detailed understanding of the knee is essential to all clinical specialties, not just sports. Enhance your understanding by taking an online course on Physiopedia plus.

Speak your mind

Your email will not be published.