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Extended report
Impact of cane use on pain, function, general health and energy expenditure during gait in patients with knee osteoarthritis: a randomised controlled trial
  1. A Jones1,
  2. P G Silva1,
  3. A C Silva1,
  4. M Colucci2,
  5. A Tuffanin2,
  6. J R Jardim2,
  7. J Natour1
  1. 1Rheumatology Division, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
  2. 2Pneumology Division, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
  1. Correspondence to Professor Dr Jamil Natour, Universidade Federal de Sao Paulo, Rua Botucatu 740, São Paulo 04023-900, Brazil; jnatour{at}


Objective To assess the impact of daily cane use during gait in relation to pain, function, general health and energy expenditure among patients with knee osteoarthritis.

Method Sixty-four patients were randomly assigned to an experimental group (EG) or control group (CG). The EG used a cane every day for 2 months, whereas the CG did not use a cane in this period. The first outcome was pain and the second were function (Lequesne and WOMAC), general health (SF-36) and energy expenditure (gas analysis during the 6-minute walk test (6MWT) with and without a cane). Evaluations were performed at baseline, 30 and 60 days.

Results The groups were homogeneous for all parameters at baseline. Compared with the CG, the EG significantly improved pain (ES 0.18), function - Lequesne (ES 0.13), some domains of SF-36 (role physical, ES 0.07 and bodily pain, ES 0.08) and distance on the 6MWT with the cane (ES 0.16). At the end of the 6MWT with the cane, the EG significantly improved energy expenditure (ES 0.21), carbon dioxide production (ES 0.12) and metabolic equivalents (ES 0.15) compared with the CG.

Conclusion A cane can be used to diminish pain, improve function and some aspects of quality of life in patients with knee osteoarthritis. The prescription of a cane should take into account the substantial increase in energy expenditure in the first month of use, whereas energy expenditure is no longer a factor for concern by the end of the second month due to adaptation to cane use.

The trial was registered in (NCT00698412).

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  • See Editorial, p 159

  • Funding This study was funded by grants provided by Fundacao Amparo a Pesquisa do Estado de Sao Paulo (2003/087536).

  • Ethics approval This study was conducted with the approval of the ethics committee of the Universidade Federal de Sao Paulo.

  • Patient consent Obtained.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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