Predictive ability of functional tests on risk of falling in older adults with knee osteoarthritis

Theardkhwan Plukwongchuen, Lalita Khuna
Purpose:

To compare functional tests including the Timed Up and Go Test (TUGT), Functional Reach Test (FRT), Alternate-Step Test (AST), Five Times Sit-to-Stand Test (FTSST), and 10-Meter Walk Test (10MWT), between older adults with knee OA who are at risk of falling and those who are not, and to investigate the ability of these tests to indicate the risk of falling in these individuals.

Methods:

A cross-sectional study was conducted with 78 participants aged 60 years and older, all diagnosed with knee OA. Each participant completed the Thai Falls Risk Assessment Test (Thai-FRAT) and was evaluated on their performance in five functional tests, administered in a random sequence. The Mann-Whitney U test was employed to compare the outcomes of these functional tests between participants at risk of falling and those without such risk. Additionally, receiver operating characteristic curves were used to determine the optimal cut-off scores for the functional tests, indicating fall risk in this population.

Results:

Among the participants, 28 older adults with knee OA were identified as having a risk of falling, while 50 were classified as having no fall risk. The ability to perform the TUGT, FRT, AST, FTSST, and 10MWT differed significantly between the two groups (p 0.05). Notably, the TUGT, with a cut-off point of >10 seconds, demonstrated the best ability to predict fall risk, showing a sensitivity of 86% and a specificity of 62%. It had the highest area under the curve (0.66, 95% CI = 0.54–0.78) compared to the other functional tests.

Conclusion(s):

Functional tests are effective in distinguishing between older adults with knee OA who are at risk of falling and those who are not. Among the functional tests assessed, the TUGT demonstrated the highest predictive ability, with a cut-off point of >10 seconds showing high sensitivity and moderate specificity to indicate fall risk in this population.

Implications:

TUGT can serve as a valuable screening tool for identifying risk of falling in older adults with knee OA, aiding in the early implementation of fall prevention strategies.

Funding acknowledgements:
This research was funded by a grant from Prince of Songkla University.
Keywords:
Osteoarthritis
Falls
Elderly
Primary topic:
Health promotion and wellbeing/healthy ageing/physical activity
Second topic:
Musculoskeletal: lower limb
Third topic:
Older people
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
The Ethics Review Committee of Human Research Ethics Unit, Faculty of Medicine, Prince of Songkla University
Provide the ethics approval number:
REC. 65-069-35-2
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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