Researcher(s)
- Samantha Huerta, Exercise Science, University of Delaware
Faculty Mentor(s)
- Karin Silbernagel, Physical Therapy, University of Delaware
Abstract
Chronic knee pain affects one in four adults in the U.S., severely impairing function and quality of life. Knee injuries, osteoarthritis (OA), and related surgeries are rising across all ages, creating a significant economic and clinical burden. Post-injury quadriceps weakness and maladaptive gait—particularly quadriceps avoidance gait—are modifiable drivers of poor outcomes and early onset OA. Current rehabilitation methods fail to correct these gait deviations or promote lasting quadriceps engagement, leaving a critical gap in clinical care. We propose a novel, low-cost intervention using a Controlled Ankle Movement (CAM) boot to provide implicit gait retraining cues. This boot alters lower limb mechanics, prompting subconscious quadriceps activation with each step by limiting ankle motion and creating leg length asymmetry. Unlike explicit verbal cues, which are cognitively demanding and difficult to retain, the CAM boot offers automatic, task-integrated feedback during real-world walking. The intervention will be rigorously evaluated using high-resolution 3D motion capture, electromyography (EMG), quadriceps strength testing, and patient-reported outcomes to quantify its impact on gait mechanics, muscle activation, and functional improvement. If successful, this approach could transform gait rehabilitation across diverse knee conditions, including ACL injuries, knee OA, and post-surgical recovery. It offers a scalable, feasible solution for physical therapy clinics aiming to improve long-term outcomes and delay or prevent OA progression. Given the prevalence of knee injuries and the high rate of progression to OA, the potential societal and economic impact is substantial, ranging from enhanced mobility and quality of life to reduced healthcare costs.