Effects of different foot progression angles and platform settings on postural stability and fall risk in healthy and medial knee osteoarthritic adults

This study aims to investigate the effects of varying toe angles at different platform settings on Overall Stability Index of postural stability and fall risk using Biodex Balance System in healthy participants and medial knee osteoarthritis patients. Biodex Balance System was employed to measure postural stability and fall risk at different foot progression angles (ranging from −20° to 40°, with 10° increments) on 20 healthy (control group) and 20 knee osteoarthritis patients (osteoarthritis group) randomly (age: 59.50 ± 7.33 years and 61.50 ± 8.63 years; body mass: 69.95 ± 9.86 kg and 70.45 ± 8.80 kg). Platform settings used were (1) static, (2) postural stability dynamic level 8 (PS8), (3) fall risk levels 12 to 8 (FR12) and (4) fall risk levels 8 to 2 (FR8). Data from the tests were analysed using three-way mixed repeated measures analysis of variance. The participant group, platform settings and toe angles all had a significant main effect on balance ( p ≤ 0.02). Platform settings had a significant interaction effect with participant group F(3, 144) = 6.97, p < 0.01 and toe angles F(21, 798) = 2.83, p < 0.01. Non-significant interactions were found for group × toe angles, F(7, 266) = 0.89, p = 0.50, and for group × toe angles × settings, F(21, 798) = 1.07, p = 0.36. The medial knee osteoarthritis group has a poorer postural stability and increased fall risk as compared to the healthy group. Changing platform settings has a more pronounced effect on balance in knee osteoarthritis group than in healthy participants. Changing toe angles produced similar effects in both the participant groups, with decreased stability and increased fall risk at extreme toe-in and toe-out angles.

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Compromised balance control in older people with bilateral medial knee osteoarthritis during level walking

Scientific Reports ◽

10.1038/s41598-021-83233-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Pei-An Lee ◽

Kuan-Hsien Wu ◽

Hsuan-Yu Lu ◽

Kai-Wen Su ◽

Ting-Ming Wang ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Fall Risk ◽

Center Of Pressure ◽

Balance Control ◽

The Elderly ◽

Rate Of Change ◽

Heel Strike ◽

Medial Knee ◽

Medial Knee Osteoarthritis ◽

Increased Risk

AbstractAbout half of the elderly population has knee osteoarthritis (OA), showing altered gait patterns with increased fall risk. The current study aimed to identify the effects of severe bilateral medial knee osteoarthritis on gait balance control, in terms of the inclination angle (IA) of the center of pressure to center of mass vector, and the rate of change of IA (RCIA). Fifteen older adults with severe bilateral medial knee OA and 15 healthy controls walked at their preferred walking speed while the kinematic and forceplate data were measured to calculate IA, RCIA and temporal–spatial parameters. The OA group showed compromised gait balance control, due to a decreased average and range of sagittal RCIA over double-limb support (DLS, p < 0.002) and single-limb support (SLS, p < 0.002), as well as an increased sagittal IA (DLS, p < 0.005). Significantly decreased frontal RCIA averages during DLS, heel-strike and toe-off, and decreased RCIA ranges during SLS and swing (p < 0.027) were also observed. Reducing RCIA during DLS appeared to help reduce the loading rate and pain at the knees, and reduced RCIA at the subsequent SLS. The results indicated an increased risk of loss of balance in the OA group, and may warrant regular monitoring for reduced RCIA during gait to determine fall risk.

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Relationship between Sensory Integration, Postural Stability and Fall Risk Assessment Parameters Using Physical Therapy for Individuals after Traumatic Brain Injury

Reabilitacijos mokslai slauga kineziterapija ergoterapija ◽

10.33607/rmske.v2i17.766 ◽

2019 ◽

Vol 2 (17) ◽

Author(s):

Ugnė Buraitytė ◽

Eglė Lendraitienė

Keyword(s):

Risk Assessment ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Sensory Integration ◽

Fall Risk ◽

Postural Stability ◽

Stability Index ◽

Balance System ◽

Biodex Balance System ◽

Anterior Posterior

Research background. Equilibrium and posture impairment is a common cause of collapse in individuals experiencing traumatic brain injury, which limits patient autonomy and independence in daily activities. Therefore, the recovery of balance is one of the primary goals of rehabilitation for individuals following the traumatic brain injury (Llorens et al., 2013). The aim was to determine the relationship between sensory integration, postural stability and fall risk assessment parameters using physiotherapy for individuals with traumatic brain injury. Methods. The study involved 16 people with traumatic brain injury. The subjects were divided into two groups – the frst one (n = 8) and the second one (n = 8). The frst group was taking 30 minutes regular physiotherapy and 30 minutes balance training with Biodex Balance System, second group – 30 min. regular physiotherapy and 30 minutes regular exercises for balance. Results. Changes in the postural stability index, anterior /posterior and medial/ lateral ﬂuctuation indexes, fall risk stability index and clinical sensory integration test index in both groups did not change statistically signifcant (p > 0.05). A strong, statistically signifcant direct relationship was found in the frst study group between the postural stability index and the ﬂuctuation of the anterior /posterior index changes (r = 0.922; p = 0.001). Conclusions. Physiotherapy using the Biodex Balance System and the usual physiotherapy is equally eﬀective in developing postural stability, sensory integration, and fall risk. The link between many of the studied indicators shows that postural stability, sensory integration and the risk of falls are related.Keywords: traumatic brain injury, sensory integration, postural stability, fall risk, physiotherapy.

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Responses to gait retraining using pressure-based auditory feedback for medial knee osteoarthritis

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2021.02.111 ◽

2021 ◽

Vol 29 ◽

pp. S81-S82

Author(s):

J. He ◽

C. Ferrigno ◽

N. Shakoor ◽

M.A. Wimmer

Keyword(s):

Knee Osteoarthritis ◽

Auditory Feedback ◽

Gait Retraining ◽

Medial Knee ◽

Medial Knee Osteoarthritis

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A comparison between laterally wedged insoles and ankle-foot orthoses for the treatment of medial osteoarthritis of the knee: A randomized cross-over trial

Clinical Rehabilitation ◽

10.1177/0269215521993636 ◽

2021 ◽

pp. 026921552199363

Author(s):

Martin Schwarze ◽

Leonie P Bartsch ◽

Julia Block ◽

Merkur Alimusaj ◽

Ayham Jaber ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Controlled Trial ◽

Oxford Knee Score ◽

Knee Adduction Moment ◽

Osteoarthritis Of The Knee ◽

Knee Score ◽

Medial Knee ◽

Medial Knee Osteoarthritis ◽

Patient Reported ◽

Angular Impulse

Objective: To compare biomechanical and clinical outcome of laterally wedged insoles (LWI) and an ankle-foot orthosis (AFO) in patients with medial knee osteoarthritis. Design: Single-centre, block-randomized, cross-over controlled trial. Setting: Outpatient clinic. Subjects: About 39 patients with symptomatic medial knee osteoarthritis. Interventions: Patients started with either LWI or AFO, determined randomly, and six weeks later changed to the alternative. Main measures: Change in the 1st maximum of external knee adduction moment (eKAM) was assessed with gait analysis. Additional outcomes were other kinetic and kinematic changes and the patient-reported outcomes EQ-5D-5L, Oxford Knee Score (OKS), American Knee Society Clinical Rating System (AKSS), Hannover Functional Ability Questionnaire – Osteoarthritis and knee pain. Results: Mean age (SD) of the study population was 58 (8) years, mean BMI 30 (5). Both aids significantly improved OKS (LWI P = 0.003, AFO P = 0.001), AKSS Knee Score (LWI P = 0.01, AFO P = 0.004) and EQ-5D-5L Index (LWI P = 0.001, AFO P = 0.002). AFO reduced the 1st maximum of eKAM by 18% ( P < 0.001). The LWI reduced both maxima by 6% ( P = 0.02, P = 0.03). Both AFO and LWI reduced the knee adduction angular impulse (KAAI) by 11% ( P < 0.001) and 5% ( P = 0.05) respectively. The eKAM (1st maximum) and KAAI reduction was significantly larger with AFO than with LWI ( P = 0.001, P = 0.004). Conclusions: AFO reduces medial knee load more than LWI. Nevertheless, no clinical superiority of either of the two aids could be shown.

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