Using Computerised Gait Analysis to Assess Changes After Rehabilitation in Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Gait Speed Improvement

Abstract

Background and objectives: Knee osteoarthritis (KOA) is a degenerative joint disorder often associated with altered gait mechanics. This systematic review aims to evaluate the effect of rehabilitation treatment on walking, with a focus on gait speed. Material and methods: A systematic search was conducted in PubMed, Scopus, Web of Science, Cochrane, and PEDro databases, following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology. Randomised controlled trials published in English between 2015 and 2025, involving patients with KOA undergoing rehabilitation and using computerised gait measurements, including 3D motion capture, force plates, and instrumented treadmills, were included. A meta-analysis was conducted on the selected studies assessing gait speed, with the risk of bias being evaluated using the Cochrane Risk of Bias 2 tool for RCTs. Results: Out of 2143 articles, 7 studies met the inclusion criteria. These studies showed increased gait speed in patients with KOA following exercise therapy, various walking training programmes, massage, or dietary interventions. The meta-analysis revealed a standardised mean difference (SMD) of 1.807, with a 95% confidence interval (CI) of [1.637, 1.977] (p < 0.001). The interventions were associated with improvements in walking parameters and quality of life, as well as reductions in pain and fall risk. Substantial heterogeneity was noted, likely due to variations in intervention types and study populations. Conclusions: The results suggest an overall improvement in gait speed in the intervention groups compared to the control groups. However, only a limited number of studies have investigated the effects of physiotherapy, bath therapy, or mud therapy on gait mechanics in patients with KOA.