Alfuth M1, Scheepers L1, Weyermann M1
1Niederrhein University of Applied Sciences, Faculty of Health Care, Therapeutic Sciences, Krefeld, Germany
Background: Balance deficits are common in people suffering from knee osteoarthritis and are associated with muscle weakness, decreased proprioception, knee instability and impaired mobility. The difference of standing balance between the affected and unaffected or less affected limb is largely unknown, however, it might be a contributing factor for or against a knee arthroplasty.
Purpose: To compare the standing balance between the affected and unaffected or less affected limb in a large cohort of people with knee osteoarthritis scheduled for total knee arthroplasty.
Methods: Four hundred and thirty patients (n=430; 78% female, 22% male; mean age: 68.9 ± 10 years) with knee osteoarthritis met the inclusion criteria for this retrospective analysis of prospectively collected data and volunteered to participate. Main inclusion criteria were the diagnosis of knee osteoarthritis using radiological examination and indication of total knee arthroplasty. After confirming the diagnosis by the attending physician, the insured patients were assigned to the outpatient physiotherapy services of a physiotherapy center. There, standardized assessments were completed at baseline of a physiotherapeutic intervention program. For the present study, data from the single-leg stance test of the affected and unaffected or less affected limb were analyzed (n=416). Throughout the test, the time (seconds) during unassisted single-leg stance on the floor with eyes open was recorded using a digital stopwatch. The significance of difference between the affected and unaffected or less affected limb was analyzed using the paired samples t-test (p 0.05).
Results: The mean time in the single-leg stance test was significantly decreased in the affected limb (12.94 ± SD 16.5 seconds) compared to the unaffected or less affected limb (17.91 ± SD 21.32 seconds) (p 0.001). The minimum value was 0 seconds and the maximum value was 60 seconds for the affected limb and 0 seconds and 150 seconds for the unaffected or less affected limb. There was a mean absolute difference of 4.97 ± SD 15.58 seconds between the limbs.
Conclusion(s): The results show that standing balance of the affected limb is decreased compared with the unaffected or less affected limb in patients with knee osteoarthritis. It has to be noted, that the values of the affected and unaffected or less affected limb in the present study are considerably lower than the mean values of healthy people of the same age as previously reported (50.42 ± SD 42.31 and 66.1 ± SD 30.7 seconds).
Implications: As impaired standing balance is considered to increase inpatient lengths of stay, predict poor rehabilitation outcomes and to enhance the risk of falling, implementing balance exercises into the physiotherapeutic treatment of patients with knee osteoarthritis seems to be crucial.
Keywords: knee osteoarthritis, balance, between-limb comparison
Funding acknowledgements: The study was funded by Deutsche Arzt AG, Essen, Germany and NOVOTERGUM AG, Essen, Germany.
Purpose: To compare the standing balance between the affected and unaffected or less affected limb in a large cohort of people with knee osteoarthritis scheduled for total knee arthroplasty.
Methods: Four hundred and thirty patients (n=430; 78% female, 22% male; mean age: 68.9 ± 10 years) with knee osteoarthritis met the inclusion criteria for this retrospective analysis of prospectively collected data and volunteered to participate. Main inclusion criteria were the diagnosis of knee osteoarthritis using radiological examination and indication of total knee arthroplasty. After confirming the diagnosis by the attending physician, the insured patients were assigned to the outpatient physiotherapy services of a physiotherapy center. There, standardized assessments were completed at baseline of a physiotherapeutic intervention program. For the present study, data from the single-leg stance test of the affected and unaffected or less affected limb were analyzed (n=416). Throughout the test, the time (seconds) during unassisted single-leg stance on the floor with eyes open was recorded using a digital stopwatch. The significance of difference between the affected and unaffected or less affected limb was analyzed using the paired samples t-test (p 0.05).
Results: The mean time in the single-leg stance test was significantly decreased in the affected limb (12.94 ± SD 16.5 seconds) compared to the unaffected or less affected limb (17.91 ± SD 21.32 seconds) (p 0.001). The minimum value was 0 seconds and the maximum value was 60 seconds for the affected limb and 0 seconds and 150 seconds for the unaffected or less affected limb. There was a mean absolute difference of 4.97 ± SD 15.58 seconds between the limbs.
Conclusion(s): The results show that standing balance of the affected limb is decreased compared with the unaffected or less affected limb in patients with knee osteoarthritis. It has to be noted, that the values of the affected and unaffected or less affected limb in the present study are considerably lower than the mean values of healthy people of the same age as previously reported (50.42 ± SD 42.31 and 66.1 ± SD 30.7 seconds).
Implications: As impaired standing balance is considered to increase inpatient lengths of stay, predict poor rehabilitation outcomes and to enhance the risk of falling, implementing balance exercises into the physiotherapeutic treatment of patients with knee osteoarthritis seems to be crucial.
Keywords: knee osteoarthritis, balance, between-limb comparison
Funding acknowledgements: The study was funded by Deutsche Arzt AG, Essen, Germany and NOVOTERGUM AG, Essen, Germany.
Topic: Musculoskeletal: lower limb; Orthopaedics; Disability & rehabilitation
Ethics approval required: No
Institution: Not applicable.
Ethics committee: Not applicable.
Reason not required: All patients included in the study gave written consent. An ethical approval was not required because the study evaluated common practice.
All authors, affiliations and abstracts have been published as submitted.
