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

Zwart, A.H. de; Esch, M. van der; Pijnappels, Mirjam; Hoozemans, M.J.M.; Leeden, M. van der; Roorda, Leo D.; Dekker, Joost; Lems, Willem F.; Dieën, Jaap H. van

doi:10.3899/jrheum.140517

Cited by 54 publications

(77 citation statements)

References 44 publications

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“…Musculoskeletal pain in this population has been linked to falls (Asai et al, 2015;de Zwart et al, 2015;Kitayuguchi et al, 2015), and the The F-statistics and corresponding P-values of Local Divergence Exponent (LDE), Root Mean Square (RMS) and magnitude of the stride-to-stride variability (SDs) from thorax movements (velocity) are reported for the anteroposterior (AP), mediolateral (ML) and vertical (VT) axes and post-hocs with Bonferroni correction for low back pain (LBP), washout (wo) LBP, calf pain (CalfP) and wo CalfP. Note that no post-hoc was performed on the significant RMS condition Â speed interaction as the effect of the condition Â axis interaction was greater.…”

Section: Discussionmentioning

confidence: 99%

“…As a result of impaired sensorimotor control, reduced gait stability is associated with aging (Kang and Dingwell, 2008) and neurological disorders (Ijmker and Lamoth, 2012;Reynard et al, 2014). Musculoskeletal pain has been associated with fall risk (Asai et al, 2015;de Zwart et al, 2015;Kitayuguchi et al, 2015) and may also impact stability. For example, spinal movement stability was lower during pain than no pain (Ross et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

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Effects of noxious stimulation to the back or calf muscles on gait stability

Hoorn

Hug

Hodges

et al. 2015

Journal of Biomechanics

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a b s t r a c tGait stability is the ability to deal with small perturbations that naturally occur during walking. Changes in motor control caused by pain could affect this ability. This study investigated whether nociceptive stimulation (hypertonic saline injection) in a low back (LBP) or calf (CalfP) muscle affects gait stability. Sixteen participants walked on a treadmill at 0.94 ms À 1 and 1.67 ms À 1 , while thorax kinematics were recorded using 3D-motion capture. From 110 strides, stability (local divergence exponent, LDE), stride-tostride variability and root mean squares (RMS) of thorax linear velocities were calculated along the three movement axes. At 0.94 ms À 1 , independent of movement axes, gait stability was lower (higher LDE) and stride-to-stride variability was higher, during LBP and CalfP than no pain. This was more pronounced during CalfP, likely explained by the biomechanical function of calf muscles in gait, as supported by greater mediolateral RMS and stance time asymmetry than in LBP and no pain. At 1.67 ms À 1 , independent of movement axes, gait stability was greater and stride-to-stride variability was smaller with LBP than no pain and CalfP, whereas CalfP was not different from no pain. Opposite effects of LBP on gait stability between speeds suggests a more protective strategy at the faster speed. Although mediolateral RMS was greater and participants had more asymmetric stance times with CalfP than LBP and no pain, limited effect of CalfP at the faster speed could relate to greater kinematic constraints and smaller effects of calf muscle activity on propulsion at this speed. In conclusion, pain effects on gait stability depend on pain location and walking speed.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of noxious stimulation to the back or calf muscles on gait stability

Hoorn

Hug

Hodges

et al. 2015

Journal of Biomechanics

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“…Eight (73%) studies reported a definition of a fall . However, the fall definition was inconsistent across the studies.…”

Section: Resultsmentioning

confidence: 99%

“…However, the fall definition was inconsistent across the studies. Some used recommended guidelines or a broad definition of a fall; others used a specific definition . There was also variation in the methods used to collect a falls history.…”

Section: Resultsmentioning

confidence: 99%

Risk Factors for Falls in Adults with Knee Osteoarthritis: A Systematic Review

Manlapaz

Sole

Jayakaran

et al. 2019

PM&R

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Objective To examine the evidence of risk factors for falls in adults with knee osteoarthritis (OA). Type Systematic Review. Methodology A systematic literature search was performed in 9 electronic databases from inception to July 2016. Two reviewers screened articles using set inclusion and exclusion criteria. Observational study designs that included participants with knee OA and history of falls were considered. Results reported as odds ratios, relative risks, prevalence ratios, or hazard ratios were extracted to identify the potential risk factors for falls. Included articles were assessed for methodological quality and level of evidence. Synthesis The electronic data search yielded 4382 studies related to falls and knee OA. A total of 11 studies were included in the review. The risk factors for falls in individuals with knee OA included impaired balance, muscle weakness, presence of comorbidities, and increasing number of symptomatic joints. The presence of knee pain was also identified as a risk factor for falls; however, the strength of evidence was rated as “conflicting” because of the inconsistency of the findings. Limited evidence was found for knee instability, impaired proprioception, and use of walking aids. Conclusion This review provides evidence of risk factors for falls in individuals with knee OA. Despite the limited to moderate evidence, identification of these risk factors may be valuable for both clinicians and fall prevention program developers. Further studies are warranted to determine which of these risk factors for falls are modifiable in a knee OA population. Level of Evidence I

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“…A study by van den Hoorn, Hug, Hodges, Bruijn, and van Dieën (2015) investigated if nociceptive stimulation and induced pain affect gait stability. Previous research suggests that musculoskeletal pain is associated with fall risk and has a negative impact on stability (Asai, Misu, Sawa, Doi, & Yamada, 2015;de Zwart et al, 2015;Kitayuguchi, Kamada, Okada, Kamioka, & Mutoh, 2015;Ross, Mavor, Brown, & Graham, 2015).…”

Section: Discussionmentioning

confidence: 99%