scholarly journals Postural Stability and Proprioception Abnormalities in Patients with Knee Osteoarthritis

2021 ◽  
Vol 11 (4) ◽  
pp. 1469
Author(s):  
Luciana Labanca ◽  
Giuseppe Barone ◽  
Stefano Zaffagnini ◽  
Laura Bragonzoni ◽  
Maria Grazia Benedetti
Keyword(s):  
Knee Osteoarthritis ◽  
Postural Stability ◽  
Functional Performance ◽  
Functional Score ◽  
Functional Abilities ◽  
Knee Score ◽  
Knee Oa ◽  
Risk Of Falls ◽  
Ongoing Assessment ◽  
And Training

Knee osteoarthritis (OA) leads to the damage of all joint components, with consequent proprioceptive impairment leading to a decline in balance and an increase in the risk of falls. This study was aimed at assessing postural stability and proprioception in patients with knee OA, and the relation between the impairment in postural stability and proprioception with the severity of OA and functional performance. Thirty-eight patients with knee OA were recruited. OA severity was classified with the Kellgren–Lawrence score. Postural stability and proprioception were assessed in double- and single-limb stance, in open- and closed-eyes with an instrumented device. Functional performance was assessed using the Knee Score Society (KSS) and the Short Performance Physical Battery (SPPB). Relationships between variables were analyzed. Postural stability was reduced with respect to reference values in double-limb stance tests in all knee OA patients, while in single-stance only in females. Radiological OA severity, KSS-Functional score and SPPB were correlated with greater postural stability impairments in single-stance. Knee OA patients show decreased functional abilities and postural stability impairments. Proprioception seems to be impaired mostly in females. In conclusion, clinical management of patients with OA should include an ongoing assessment and training of proprioception and postural stability during rehabilitation.

scholarly journals EVALUATION OF OUTCOME OF MEDIAL OPENING WEDGE HIGH TIBIAL OSTEOTOMY FOR UNICOMPARTMENTAL KNEE OSTEOARTHRITIS

2020 ◽  
pp. 1-4
Author(s):  
R. N. Shewale ◽  
Ketan J. Khatri
Keyword(s):  
Knee Osteoarthritis ◽  
Functional Outcome ◽  
High Tibial Osteotomy ◽  
Medial Compartment ◽  
Functional Score ◽  
Tibial Osteotomy ◽  
Knee Score ◽  
Opening Wedge ◽  
Wedge High Tibial Osteotomy ◽  
The Mean

Background: Osteoarthritis is often found in weight-bearing joints, the knee being the most common site. Most patients of symptomatic osteoarthritis of knee are associated with varus malalignment that is causative or contributory to painful arthritis. Correcting the malalignment of the knee relieves symptoms by transferring the functional load to the unaffected compartment. The goal of the treatment is to relieve medial compartment knee pain and slow down the arthritic progression. We report the outcome of a simple technique of medial opening wedge high tibial osteotomy in treating the medial compartment osteoarthritis of the knee. Materials and method: A prospective interventional study was carried out over a period of 2 years from November 2017 to October 2019 in a sample size of randomly selected 41 patients having unilateral knee osteoarthritis. All patients after a proper preoperative assessment underwent high tibial osteotomy and the outcome was evaluated using knee society scoring system. Results: The age of the patients ranged from 40 – 65 years with a mean age of 51 years, 13 were males and 28 were females showing female predominance (68.2%). The mean knee score and the mean functional score of the patients before surgery were 60 and 61.95 respectively and post operatively at the end of 6 months the knee score and functional score was 77 and 80.53 respectively. By the end of 6 months out of 41 patients, 12 patients (29.2%) had excellent functional outcome, 18 patients (43.90%) had good functional outcome, 09 patients (21.95%) had fair functional outcome while only 02 patients (04.87%) had poor functional outcome. Conclusions: The present study shows that HTO is a good option in isolated medial compartment OA of knee. Significant increase in the knee score and functional score was found after high tibial osteotomy for the patients of osteoarthritis with varus deformity. Success of high tibial osteotomy relies on appropriate patient selection, proper osteotomy type and precise surgical technique.

scholarly journals Neuromuscular exercises: A new perspective in knee osteoarthritis

2021 ◽  
Vol 20 (3) ◽  
pp. 311-316
Author(s):  
Jyoti Sabharwal ◽  
◽  
Shabnam Joshi ◽  
Keyword(s):  
Knee Osteoarthritis ◽  
Functional Performance ◽  
Thigh Muscle ◽  
Intervention Programme ◽  
Limb Weakness ◽  
Knee Oa ◽  
Increased Risk ◽  
New Perspective ◽  
Training Programmes

Background. Knee osteoarthritis (OA) is the most prevalent arthropathy across the world. It presents with swelling, pain, decreased range of motion (ROM) and instability. Patients also complain of thigh muscle weakness and lower limb weakness resulting in poor joint shielding and joint overload. Owing to these presenting features patients are prone to increased risk of morbidity and are forced to live with functional impairment. Exercises are one of the vital intervention programme used in knee OA. Exercises lead to improvement in physical function, strengthening of the muscles and reduction in pain. Neuromuscular exercises have effects on functional performance, biomechanics and activation pattern of surrounding musculatures of the patient. Therefore, neuromuscular exercises may prove to be beneficial in enhancing the efficacy of exercise training programmes in such patients due to functional instability and disturbed neuromuscular function. Purpose. This article intends to review the effect and role of neuromuscular exercises in the management of knee osteoarthritis. Method. Comprehensive computerized search was performed on Google Scholar, Pubmed and Cochrane. Conclusion. By evaluating various articles on neuromuscular exercises in knee osteoarthritis the present review suggest that neuromuscular exercises are helpful in the treatment of knee osteoarthritis.

scholarly journals Sarcopenic Knee Osteoarthritis: A Risk Factor for Recurrent Falls

2021 ◽  
Author(s):  
Hirotaka Iijima ◽  
Tomoki Aoyama
Keyword(s):  
Older Adults ◽  
Knee Osteoarthritis ◽  
Knee Oa ◽  
Recurrent Falls ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Interactive Relationship ◽  
Falls In Older Adults ◽  
Risk Factors For Falls ◽  
And Control

Abstract Background: Sarcopenia and knee osteoarthritis (OA) are major risk factors for falls in older adults. The coexistence of these two conditions may exacerbate the risk of falls through the sarcopenia-OA interaction. This study aimed to test the hypothesis that older adults with coexisting sarcopenia and knee OA, defined as “sarcopenic OA,” displayed an increased risk of falls.Methods: Patients in an orthopedics clinic (n = 298, age: 60–90 years, 78.9% women) were divided into 4 groups according to the presence of sarcopenia and radiographic knee OA: isolated sarcopenia, isolated knee OA, sarcopenic knee OA, and control (i.e., non-sarcopenia with non-OA) groups. We used questionnaires to assess fall experience in the prior 12 months. We performed binary and ordinal logistic regression analyses to evaluate the relationship between the 4 groups and falls experience.Results: Of 298 participants, 27 (9.1%) had sarcopenic knee OA. Patients with sarcopenic knee OA had 4.70 times (95% confidence interval: 1.08, 20.5) higher odds of recurrent falls (≥ 2 falls) than those with control after adjustment for age, sex, and body mass index.Conclusions: Patients with sarcopenic knee OA displayed higher frailty. This study provides novel interactive relationship between sarcopenia and knee OA in the context of recurrent falls experience.Trial registration: Not applicable.

scholarly journals Phisical modalities on the functional performance in knee osteoarthritis: a sytematic review

2017 ◽  
Vol 30 (3) ◽  
pp. 607-623 ◽  
Author(s):  
Letícia Ferronato ◽  
Hemily Marega Cunha ◽  
Pâmela Maiara Machado ◽  
Gabriela dos Santos de Souza ◽  
Mirieli Denardi Limana ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Knee Osteoarthritis ◽  
Functional Performance ◽  
Life Quality ◽  
Low Level Laser Therapy ◽  
Ultrasound Therapy ◽  
Pulsed Ultrasound ◽  
Eligibility Criteria ◽  
Knee Oa ◽  
Physical Modalities

Abstract Introduction: Despite recent advances in the treatment of osteoarthritis (OA), few studies have evaluated the longitudinal effect of physical modalities in functional capacity in patients with knee OA. Thereby, since the physical components and pain can affect the functional performance of daily activities, the effect of these treatment’s form is still to be established. Objective: Evaluate the effectiveness of therapeutic ultrasound, electrical stimulation and phototherapy in the functional performance, in patients with knee osteoarthritis. Methods: Articles present in the PubMed, Lilacs, SciELO and PEDro’s databases were evaluated. The used keywords were “pulsed ultrasound therapy”, “ultrasound therapy”, “electric stimulation” and “low level laser therapy” in combination with “knee osteoarthritis”. Were included in this presented review, randomized clinical studies using ultrasound, electrical and laser stimulation in subjects with knee osteoarthritis. To evaluate the methodological quality of the selected studies, was used the PEDro’s scale. The dependent variables of the study were: pain, physical function, joint stiffness, life quality and functional performance. Results: 268 studies were found, of these, 41 studies met eligibility criteria and were classified for analysis in full. The used methodology in the studies varied widely, however, in most cases there was improvement in functional performance of individuals with knee OA, with the use of physical modalities, for the pulsed ultrasound, continuous ultrasound, electrical stimulation and laser resourses. Conclusion: The physical modalities used in the studies demonstrated improvement in functional performance of individuals with knee OA.

The Effect of Patellar height by using Insall Salvati Index on Pain, Function, Muscle Strength and Postural Stability in Patients with Primary Knee Osteoarthritis

2020 ◽  
Vol 16 ◽  
Author(s):  
Pinar Doruk Analan ◽  
Hulya Ozdemir
Keyword(s):  
Muscle Strength ◽  
Knee Osteoarthritis ◽  
Physical Function ◽  
Fall Risk ◽  
Postural Stability ◽  
Patellar Height ◽  
Knee Oa ◽  
American College Of Rheumatology ◽  
Isokinetic Muscle Strength ◽  
The Mean

Purpose: The Insall-Salvati Index (ISI) is the ratio of the patellar tendon length to the length of the patella. This ratio is the most commonly used method for evaluating patellar placement and patellofemoral imbalance. The position of the patella is important for the knee joint function and also biomechanics. The abnormal position of the patella may lead to patellofemoral malalignment and instability. Herein, we aimed to analyze the relationship between the ISI and pain, physical function, muscle strength, fall risk and postural stability in patients with primary knee osteoarthritis (OA). Methods: 62 sympthomatic knees of 45 patients (aged between 40 -75 years) who were suffering from the primary knee OA according to the American College of Rheumatology criteria were included retrospectively in the study. Patients with stages II and III osteoarthritis according to the Kellgren-Lawrence (K/L) radiological grading system were included. The ISI was measured on the lateral knee radiograph in a 30° flexed posture. Visual Analogue scale (VAS), Western Ontario and McMaster Universities Osteoarthritis (WOMAC) and Lequesne indexes were recorded for evaluating pain and function. Tetrax Interactive Balance System was used to assess fall risk and postural stability. Isokinetic muscle strength measurements of quadriceps and hamstrings were recorded at the constant angular velocities of 60 and 180°/sec. Results: The mean age of the study population was 58.52 ±8.01 years. Th The frequency of the patellar situation types were as follows; patella alta; 15 (24.2%), patella baja; n=2(3.2%), normal patellar height; n=45(72.6%). The mean ISI was found 1.19 ±0.17 on the right side and 1.18±0.16 on the left side. There was not any significant correlation between the ISI and VAS, WOMAC and Lequesne indexes, postural stability scores and isokinetic measurements (r<0.3, p>0.05). Conclusions: In primary knee OA, the ISI may not have an effect on pain, physical function, fall risk, postural stability, and isokinetic muscle strength.

QUADRICEPS STRENGTH, KNEE PAIN AND FUNCTIONAL PERFORMANCE WITH PATELLAR TAPING IN KNEE OSTEOARTHRITIS

2014 ◽  
Vol 17 (03) ◽  
pp. 1450014 ◽  
Author(s):  
Abeer Farag Hanafy ◽  
Amira Abdallah Abd El Megeid Abdallah
Keyword(s):  
Knee Osteoarthritis ◽  
Functional Performance ◽  
Quadriceps Muscle ◽  
Quadriceps Strength ◽  
Stair Climbing ◽  
Walking Distance ◽  
Knee Oa ◽  
Symptomatic Knee ◽  
Vas Scores ◽  
Patellar Taping

Background: Patellar taping has long been reported to be effective in relieving pain in patients with patello-femoral pain syndrome (PFPS). Yet, there is lack of knowledge that supports its use in knee osteoarthritis (OA) management. Purpose: This study examined the effect of therapeutic patellar taping on concentric and eccentric quadriceps muscle peak torques, VAS pain scores, 6-minute walking distance and stair climbing time in patients with knee OA. Methods: A total of 30 female patients with symptomatic knee OA with mean age 51.8 ± 6.3 years and BMI 32.56 ± 3.26 m2/kg participated in the study. They were tested under three taping conditions that were tested randomly; therapeutic, placebo and no-tape. Results: Repeated measure MANOVA revealed that the quadriceps muscle peak torques and 6-minute walking distance increased significantly (p < 0.05) and the VAS scores and stair climbing time decreased significantly with therapeutic tape use compared with the other two tapes. Moreover, the quadriceps muscle peak torques increased significantly and the VAS scores decreased significantly with placebo tape use compared with no-tape use, with no significant difference (p > 0.05) in between for the 6-minute walking distance and stair climbing time. Conclusion: The findings indicate that therapeutic patellar taping is effective in improving quadriceps strength and functional performance and reducing pain in patients with knee OA.

scholarly journals Increased recurrent falls experience in older adults with coexisting of sarcopenia and knee osteoarthritis: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hirotaka Iijima ◽  
Tomoki Aoyama
Keyword(s):  
Older Adults ◽  
Knee Osteoarthritis ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Knee Oa ◽  
Recurrent Falls ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Risk Factors For Falls

Abstract Background Sarcopenia and knee osteoarthritis (OA) are two major risk factors for falls in older adults. The coexistence of these two conditions may exacerbate the risk of falls. This cross-sectional study aimed to test the hypothesis that older adults with coexisting sarcopenia and knee OA displayed an increased risk of falls experience. Methods Participants recruited from an orthopedic clinic were divided into four groups according to the presence of sarcopenia and radiographic knee OA: isolated sarcopenia, isolated knee OA, sarcopenia + knee OA, and control (i.e., non-sarcopenia with non-OA) groups. We used questionnaires to assess falls experience in the prior 12 months. We performed logistic regression analyses to evaluate the relationship between the four groups and falls experience. Results Of 291 participants (age: 60–90 years, 78.7% women) included in this study, 25 (8.6%) had sarcopenia + knee OA. Participants with sarcopenia + knee OA had 4.17 times (95% confidence interval: 0.84, 20.6) higher odds of recurrent falls (≥2 falls) than controls after adjustment for age, sex, and body mass index. The increased recurrent falls experience was not clearly confirmed in participants with isolated sarcopenia and isolated knee OA. Conclusions People with coexisting of sarcopenia and knee OA displayed increased recurrent falls experience. This study suggests a new concept, “sarcopenic knee OA”, as a subgroup associated with higher risk of falls, which should be validated in future large cohort studies. Trial registration. Not applicable.

scholarly journals The Effect of Balance Training in Knee Osteoarthritis

2020 ◽  
pp. 246-255
Author(s):  
Marwa Mohamed Alawady Elsheikh ◽  
Marwa Ahmed Abo El-Hawa ◽  
Hanan Mohamed El-saadany ◽  
Mervat Abd El Sattar Elsergany
Keyword(s):  
Knee Osteoarthritis ◽  
Postural Stability ◽  
Balance Training ◽  
Rehabilitation Program ◽  
Stability Test ◽  
Range Of Movement ◽  
Limits Of Stability ◽  
Knee Oa ◽  
Group I ◽  
Strength Exercises

Background: Osteoarthritis (OA) is the most common chronic disease that affects joints; especially knee joints. OA causes progressive irreversible joint damage and finally joint failure. Proprioceptive deficits are greater in people with knee OA. Objective: The aim of this study is to assess and evaluate the effect of balance training as an additional modality in management of mild and moderate knee osteoarthritis and its effect on clinical and functional outcome. Methods: The study included 60 patients with primary knee osteoarthritis, consecutively selected from outpatient clinic of Physical Medicine, Rheumatology and Rehabilitation Department, Faculty of Medicine, Tanta University Hospitals. They were divided into two groups: Group I:  (30) Patients was trained by strength exercises rehabilitation program in addition to training program of the BSS-SD. Three sessions per week for twelve weeks. Group II: (30) Patients were trained by strength exercises rehabilitation program only by three sessions per week for twelve weeks. Patients were assessed by clinical evaluation (visual analogue scale (VAS), Ritchie's tenderness scale, morning stiffness, range of motion) physical performance assessments by chair stand test, functional assessment by WOMAC, assessment of postural stability and balance disturbance (postural stability test- fall risk test- limits of stability test) were performed before, 6 and 12 weeks after rehabilitation programs Results: Our study showed improvement in both groups of clinical assessment (VAS of pain, tenderness, morning stiffness) also there was significant improvement of (active range of movement and passive range of movement and CST). There was significant improvement of pain assessed by WOMAC. There was significant improvement of (postural stability test, fall risk testing, and limits of stability).  There were improvement in-group I more significant than group II. Conclusion: Combined therapy of strength exercises rehabilitation program and training program of balance by BSS-SD have more potential effects in treatment of mild and moderate knee OA better than strength exercises rehabilitation program only.

scholarly journals Effects of Textured Insoles on the Balance of Individuals with Knee Osteoarthritis in Dynamic Perturbations

2021 ◽  
Vol 11 (18) ◽  
pp. 8615
Author(s):  
Hyoungjin Park
Keyword(s):  
Knee Osteoarthritis ◽  
Balance Performance ◽  
Sensory Organization Test ◽  
Plantar Surface ◽  
Knee Oa ◽  
Sensory Organization ◽  
Healthy Knee ◽  
Risk Of Falls ◽  
Somatosensory Function

The effectiveness of adding plantar-surface texture to improve balance has been demonstrated in a variety of demographics. It is critical to investigate whether textured insoles can improve balance in people with knee osteoarthritis (OA), who have compromised the somatosensory function of the affected joint and, as a result, are at a higher risk of falling. Thus, this study investigated the degree of benefit from the use of textured insoles for improving balance and compared the balance of people with knee OA to healthy matched peers. This study included eighteen people with knee OA and eighteen healthy, aged, gender, height, weight, and BMI matched controls who were assessed on balance using the sensory organization test and the motor control test. Balance was improved in both groups when the textured insoles were worn, and the healthy knee group demonstrated significantly better balance performance than the knee OA group. The benefits of this study for individuals with knee OA are that it may lead to the development of an evidence-based footwear intervention that is noninvasive, simple to use, and inexpensive, in addition to allowing the user to self-manage and the ability to reduce the risk of falls, thereby improving their quality of life.

scholarly journals Falls Associated with Muscle Strength in Patients with Knee Osteoarthritis and Self-reported Knee Instability

2015 ◽  
Vol 42 (7) ◽  
pp. 1218-1223 ◽  
Author(s):  
Arjan H. de Zwart ◽  
Martin van der Esch ◽  
Mirjam A.G.M. Pijnappels ◽  
Marco J.M. Hoozemans ◽  
Marike van der Leeden ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Statistical Power ◽  
Multivariate Logistic Regression Analysis ◽  
Knee Extension ◽  
Knee Instability ◽  
Valgus Knee ◽  
Knee Oa ◽  
Risk Of Falls

Objective.We aimed to evaluate the associations between knee muscle strength (MS) and falls, controlling for knee joint proprioception, varus-valgus knee joint laxity, and knee pain, among patients with knee osteoarthritis (OA) reporting knee instability.Methods.A sample of 301 subjects (203 women, 98 men, 35–82 yrs) with established knee OA and self-reported knee instability was studied. The occurrence of at least 1 fall in the previous 3 months was assessed by questionnaire. Maximum knee extension and flexion strength were measured isokinetically. Additionally, proprioception, varus-valgus laxity, and pain were assessed. Student t tests were used to assess differences between subgroups. The association of muscle strength and falls was calculated using univariate and multivariate logistic regression analysis.Results.Over 10% of the subjects (31 out of 301) reported a fall in the previous 3 months. High knee extension muscle strength (crude OR 0.3, 95% CI 0.1–0.8, p = 0.022) and high knee flexion muscle strength (crude OR 0.2, 95% CI 0.0–1.0, p = 0.048) were associated with a lower risk of falls. Proprioception and laxity did not confound this relationship. After adjusting for pain, extensor strength had an adjusted OR of 0.5 (95% CI 0.2–1.4, p = 0.212) for falls and flexor strength had an adjusted OR of 0.4 (95% CI 0.1–2.3, p = 0.312).Conclusion.High knee extension and flexion muscle strength decreased the risk of falls in patients with knee OA and self-reported knee instability. After considering the effect of pain, there was insufficient statistical power to detect an association between muscle strength and falls, which might be because of the low number of subjects who fell (n = 31).

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