1000 Section - Effectiveness of Wearable Device-Assisted Gait Retraining in Female Runners with Patellofemoral Pain: A Randomized Controlled Trial

Objectives : This study investigated the short- and mid-term effects of wearable device–assisted gait retraining on pain, function, running mechanics, and patellofemoral joint loading in runners with patellofemoral pain (PFP).

Design:

Forty-four runners were randomly assigned to a gait retraining group or an education-only control group. The control group received online materials covering PFP mechanisms, knee protection strategies, load management, and quadriceps/hip strengthening, and modified their running based on symptoms while maintaining pain ≤3/10. The gait retraining group received the same education plus a 6-week cadence-based gait retraining program (twice weekly), aimed at increasing step rate by 10% using a wearable smartwatch providing real-time cadence and metronome feedback. Pain and function were assessed using VAS-R, VAS-U, VAS-W, and AKPS at baseline, week 6, and week 18. Running mechanics—including step rate, weekly running distance, knee flexion angle, knee extensor moment, patellofemoral joint reaction force, patellofemoral stress, ground reaction force, and vertical loading rate—were measured at baseline and week 6 using 3D motion capture and force plate analysis. Between-group differences were estimated using linear regression models.

Results: The gait retraining group showed greater reductions in running pain, worst pain, pain with ADL, and greater improvements in AKPS at both 6 and 18 weeks compared with controls. Step rate increased significantly, accompanied by reductions in weekly running distance. Biomechanically, gait retraining led to substantial decreases in peak knee extensor moment, patellofemoral joint reaction force, patellofemoral stress, and vertical loading rate, while controls exhibited minimal changes.

Conclusion:

Wearable-assisted gait retraining leads to superior improvements in symptoms, function, and patellofemoral joint loading, supporting its value as an effective biomechanical intervention for PFP management.