Systems, devices, and method for the treatment of osteoarthritis

Abstract

The present disclosure describes devices, methods and systems for modifying or altering gait kinematics via sensory augmentation and/or modifying muscle activation patterns via augmented motor learning to slow the progression of and/or reduce the pain associated with knee OA, particularly during gait (e.g., walking, running, stair climbing, etc.). Sensors can be used to measure gait parameters and characteristics and muscle activation patterns. Stimulation can be provided to the individual in order to promote learning new gait kinematics and muscle activation patterns.

1 . (canceled) 
     
     
         2 . (canceled) 
     
     
         3 . (canceled) 
     
     
         4 . (canceled) 
     
     
         5 . (canceled) 
     
     
         6 . (canceled) 
     
     
         7 . (canceled) 
     
     
         8 . (canceled) 
     
     
         9 . (canceled) 
     
     
         10 . (canceled) 
     
     
         11 . (canceled) 
     
     
         12 . (canceled) 
     
     
         13 . (canceled) 
     
     
         14 . (canceled) 
     
     
         15 . (canceled) 
     
     
         16 . (canceled) 
     
     
         17 . (canceled) 
     
     
         18 . (canceled) 
     
     
         19 . (canceled) 
     
     
         20 . (canceled) 
     
     
         21 . (canceled) 
     
     
         22 . (canceled) 
     
     
         23 . (canceled) 
     
     
         24 . A method for reducing knee pain associated with osteoarthritis in an individual, the method comprising:
 measuring a gait parameter;   determining a deviation of the measured gait parameter from a set range or value for the gait parameter;   delivering a sensory stimulation to the individual based on the determined deviation of the measured gait parameter; and   altering the individual's gait kinematics such that the deviation of the measured gait parameter is reduced in subsequent measurements of the gait parameter.   
     
     
         25 . The method of  claim 24 , wherein the gait parameter is selected form the group consisting of foot angle, step width, knee angle, and knee adduction moment. 
     
     
         26 . The method of  claim 24 , wherein the set range or value is predetermined. 
     
     
         27 . The method of  claim 24 , wherein the sensory stimulation is delivered in a fading feedback manner. 
     
     
         28 . The method of  claim 24 , wherein the sensory stimulation is electrical and is configured to not induce contraction of a muscle. 
     
     
         29 . The method of  claim 28 , wherein the electrical sensory stimulation is configured to enhance motor plasticity. 
     
     
         30 . The method of  claim 24 , further comprising:
 measuring an activation of the gastrocnemius muscle; and   delivering a second sensory stimulation based on the activation of the gastrocnemius muscle to inform the individual of the activation of the gastrocnemius muscle.   
     
     
         31 . The method of  claim 30 , further comprising:
 measuring an activation of a soleus muscle; and   delivering a third sensory stimulation based on the activation of the soleus muscle to inform the individual of the activation of the soleus muscle.   
     
     
         32 . The method of  claim 24 , further comprising delivering a stimulation configured to reduce an excitability of the gastrocnemius muscle. 
     
     
         33 . The method of  claim 24 , further comprising delivering a stimulation configured to enhance an excitability or activate a soleus muscle. 
     
     
         34 . The method of  claim 24 , further comprising:
 measuring an activation of the gastrocnemius muscle;   measuring an activation of a soleus muscle;   delivering a second sensory stimulation based on the activation of the gastrocnemius muscle to inform the individual of the activation of the gastrocnemius muscle;   delivering a third sensory stimulation based on the activation of the soleus muscle to inform the individual of the activation of the soleus muscle;   delivering a stimulation configured to reduce an excitability of the gastrocnemius muscle; and   delivering a stimulation configured to enhance an excitability or activate a soleus muscle.   
     
     
         35 . A method for reducing knee pain associated with osteoarthritis in an individual, the method comprising:
 measuring a plurality of gait parameters;   determining a deviation of each of the measured gait parameters from a set range or value for each of the gait parameters;   prioritizing the plurality of gait parameters based on the determined deviations;   identifying a high priority gait parameter based on the step of prioritizing the plurality of gait parameters;   delivering a sensory stimulation to the individual based on the high priority gait parameter; and   altering the individual's gait kinematics.   
     
     
         36 . The method of  claim 35 , wherein the sensory stimulation is delivered to a peripheral nerve in the leg. 
     
     
         37 . The method of  claim 35 , wherein the sensory stimulation is delivered to a sensory nerve in the leg. 
     
     
         38 . A method for reducing knee pain associated with osteoarthritis in an individual, the method comprising:
 measuring a plurality of gait parameters;   measuring activation of the gastrocnemius muscle;   determining a deviation of each of the measured gait parameters from a set range or value for each of the gait parameters;   prioritizing the plurality of gait parameters based on the determined deviations;   identifying a high priority gait parameter based on the step of prioritizing the plurality of gait parameters;   comparing the identified high priority gait parameter with the measured activation of the gastrocnemius muscle;   delivering a sensory stimulation to the individual based on the comparison of the high priority gait parameter with the measured activation of the gastrocnemius muscle; and   altering the individual's gait kinematics or muscle pattern activation.   
     
     
         39 . The system of  claim 38 , wherein the sensory stimulation comprises a stimulation parameter selected from the group consisting of: amplitude, frequency, pulse width, duration, and waveform shape.