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Optimising the efficacy of gait retraining
  1. Irene Davis
  1. Correspondence to Professor Irene Davis, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts 02138, USA; isdavis{at}partners.org

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A recent randomised control trial compared the effects of three rehabilitation programmes for patellofemoral pain: education, education and exercises and education and gait retraining.1 I was excited to read this, as I consider gait retraining an important component of patellofemoral pain treatment. Physical therapists are movement experts and in the best position to address faulty movement patterns. Many running-related injuries, especially those more chronic and requiring medical attention, are associated with faulty running mechanics.2 Muscle strengthening alone may not address faulty mechanics.3 While muscle strength is important and can be considered the ‘hardware’ of movementit is the motor pattern, or the ‘software’, that dictates the movement quality. When movement patterns become habitual, altering them during high demand, functional activities such as running takes time and practice and can be challenging.

The goal of gait retraining is to adopt and retain a new motor pattern. Research suggests that this requires an acquisition phase, where extrinsic feedback is provided on a predetermined schedule so that the learner can associated the feedback with their proprioceptive input.4 This is followed by …

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