Visual knee-kinetic biofeedback technique normalizes gait abnormalities during high-demand mobility after total knee arthroplasty

Jesse C. Christensen, Paul C. LaStayo, Robin L. Marcus, Gregory J. Stoddard, K. Bo Foreman, Ryan L. Mizner, Christopher L. Peters, Christopher E. Pelt

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Background: Abnormal knee mechanics frequently follow total knee arthroplasty (TKA) surgery with these deficits amplifying as task demands increase. Knee-kinetic biofeedback could provide a means of attenuating gait abnormalities. The purposes of this study were as follows: (1) to describe the gait characteristic differences between patients with TKA and non-TKA adults during level (low-demand) and decline (high-demand) walking; and (2) where differences existed, to determine the impact of knee-kinetic biofeedback on normalizing these abnormalities. Methods: Twenty participants six months following a primary TKA and 15 non-TKA peers underwent gait analysis testing during level and decline walking. Knee-kinetic biofeedback was implemented to patients with TKA to correct abnormal gait characteristics if observed. Results: Patients with TKA had lower knee extensor angular impulse (p < 0.001), vGRF (p = 0.001) and knee flexion motion (p = 0.005) compared to the non-TKA group during decline walking without biofeedback. Patients with TKA normalized their knee extensor angular impulse (p = 0.991) and peak vGRF (p = 0.299) during decline walking when exposed to biofeedback. No between-group differences were observed during level walking. Groups were similar in age, gender, body mass index, physical activity level, pain interference and depression scores (p > 0.05). Conclusion: Patients with TKA demonstrate abnormal gait characteristics during a high-demand walking task when compared to non-TKA peers. Our findings indicate that knee-kinetic biofeedback can induce immediate improvements in gait characteristics during a high-demand walking task. There may be a potential role for the use of visual knee-kinetic biofeedback techniques to improve gait abnormalities during high-demand tasks following TKA.

Original languageEnglish
Pages (from-to)73-82
Number of pages10
Issue number1
StatePublished - Jan 2018


  • Biofeedback
  • Gait characteristics
  • Total knee arthroplasty


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