The short-term stability and reliability of daily estimates of posttraumatic stress disorder symptoms.

Osteoarthritis is a leading cause of disability among adults, affecting 22% of individuals over the age of 40. The knee is the most common site of symptomatic osteoarthritis, and excessive compressive loading during walking accelerates osteoarthritis progression. Isolated medial compartment osteoarthritis is three times more prevalent than isolated lateral compartment osteoarthritis, likely because roughly 70% of compressive force is transmitted through the medial compartment during walking. The knee adduction moment is a surrogate measure for the medio-lateral distribution of compressive loading, and the knee adduction moment peak during walking relates to the progression of medial knee osteoarthritis. Loading can be shifted from the medial to the lateral compartment by reducing the knee adduction moment; thus, reducing the knee adduction moment peak is a target for conservative interventions, like gait modifications. Altering the foot progression angle (i.e., toeing-in or toeing-out) is a subtle way to reduce the knee adduction moment that is preferred by patients over more conspicuous gait modifications and can be delivered inexpensively in a clinic or with a wearable device. Previous studies showed that assigning the same toe-in or toe-out gait modification to individuals with medial knee osteoarthritis reduced pain on average; however, these studies did not have control groups, and not all participants reduced their knee adduction moment peak or pain. A trial that retrained all individuals to toe-out did not find a pain improvement that was significantly greater than the control group. Compared to assigning the same foot progression angle to all individuals, assigning a personalized foot progression angle modification produces greater reductions in the knee adduction moment peak, while avoiding a potentially harmful increase in loading. The importance of personalizing gait modifications is reinforced by the short-term pain reductions elicited by instructing patients to change their gait in any way possible to reduce the visually displayed knee adduction moment curve. Recent gait retraining randomized trials have provided control participants with supervised walking but not sham biofeedback on their gait mechanics, which may have a large placebo effect. Personalized foot progression angle modifications appear to be an effective and scalable way to reduce the knee adduction moment, but their clinical efficacy compared to sham gait retraining remains unknown. The treatment of early-stage osteoarthritis primarily focuses on symptom management. Treatments that reverse, halt, or slow disease progression are needed. Previous studies of interventions that reduce the knee adduction moment have not demonstrated an effect on disease progression, likely because conventional imaging methods, like radiographs, are unable to detect early compositional and structural changes in cartilage. T and T relaxation times are quantitative Magnetic Resonance Imaging (MRI) parameters that are often used to monitor cartilage degeneration, due to their association with proteoglycan content and collagen matrix integrity, respectively. Quantitative MRI is sensitive to subtle cartilage changes due to disease progression over one year, with increasing T and T values associated with increasing cartilage degeneration. Furthermore, T and T predict the progression of cartilage lesions and the reduction in function at 2 years, while cartilage morphology (i.e., cartilage thickness) does not. Quantitative MRI is also sensitive to cartilage changes induced by joint offloading. The high sensitivity of quantitative MRI to microstructural and compositional changes in cartilage and its ability to predict disease progression makes it an ideal candidate to monitor the effect of load-reducing interventions like gait retraining.