Gait-training devices in the treatment of lower extremity injuries in sports medicine: current status and future prospects

Introduction: This review seeks to provide synthesized information on gait-training techniques and devices applied, in four of the most prevalent chronic lower extremity injuries seen in sports medicine.

Areas covered: Comprehensive searches were performed in CINAHL and PubMed databases in April 2018 to identify gait-training articles in Chronic Ankle Instability (CAI), Exercise-Related Lower Leg Pain (ERLLP), Patellofemoral Pain (PFP), and Anterior Cruciate Ligament with Reconstruction (ACLR) populations. An investigator reviewed the articles and extracted data including study demographics, gait-training techniques, devices used, and primary gait-training outcomes. Fifty-eight articles were included in this review (9 CAI, 19 ERLLP, 17 PFP, 13 ACLR). Pooled analyses were performed for common outcomes within each injury category. Current evidence supports destabilization training and pressure medialization tactics for CAI (n = 9), footstrike/loading and cadence interventions for ERLLP (n = 11) and PFP (n = 7), and limb off-loading techniques for ACLR (n = 4). Commonly used devices included accelerometers (n = 6), custom gait-training footwear (n = 9), metronomes (n = 14), and pressure sensors (n = 5).

Expert commentary: Although there are commonalities among gait-training interventions for chronic pathologies, more uniform approaches and clinical predictor rules would help identify the most appropriate interventions. Wearable sensors will continue to revolutionize gait-training and allow for ecologically valid gait-training interventions.