Physiological risk factors for falls in people with knee osteoarthritis before and early after knee replacement surgery

Levinger, Pazit; Menz, Hylton B.; Wee, Elin; Feller, Julian A.; Bartlett, John R.; Bergman, Neil R.

doi:10.1007/s00167-010-1325-8

Cited by 132 publications

(153 citation statements)

References 54 publications

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“…The same resear chers obtained a mean discrepancy of 2.3º among the controls, which is also lower than the one recorded in the present study [27]. Levinger et al assessed joint proprioception before knee arthroplasty and at four months after the surgery, recording a mean score of 1.8º compared to 1.3º in the control group on both occasions [10]. However, it is difficult to determine the measurement angle and the manner of the test performance, since the report does not provide a detailed description of the methods.…”

Section: Discussioncontrasting

confidence: 47%

“…In nym czyn ni kiem są nie wy rów na ne pro ble my zwią za ne z ukła dem krą że -nia, któ re mo gą po wo do wać na głe sko ki ci śnie nia i za wro ty gło wy po cho dze nia krą że nio we go [7]. Opi sa ne me cha ni zmy i czyn ni ki pro wa dzą do po gorsze nia funk cji lo ko mo cji i zwięk sze nia ry zy ka upadków, któ re nio są za so bą po wa żne kon se kwen cje w po sta ci ogra ni cze nia spraw no ści i sa mo dziel no ści czy dłu gie go unie ru cho mie nia, mo gą ce go pro wa dzić do zgo nu [7,9,10].…”

Section: Wstępunclassified

“…Another factor is uncon trolled cardiovascular problems which may cause sudden rises in blood pressure and circulationrelated vertigo [7]. The above mechanisms and fac tors im pair locomotion and increase the risk of falls, which may have serious consequences, such as limi tation in physical capacity and independence or pro lon ged immobilisation, which may lead to death [7,9,10].…”

Section: Introductionmentioning

confidence: 99%

“…ni wy nik 1,8º w po rów na niu do 1,3º w gru pie kon trol nej (zdro wej) [10]. Du że wąt pli wo ści w ich ba da niu bu dzi jed nak brak opi su szcze gó ło wej me to dy ki testu -na pod sta wie pre zen to wa ne go przez ten ze spół do nie sie nia nie spo sób okre ślić ką ta, w któ rym przepro wa dza no ba da nie ani spo so bu je go wy ko na nia.…”

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Impact of Knee Arthroplasty on Knee sensorimotor System Performance

Słupik¹,

Kowalski²,

Białoszewski³

2013

Ortop Traumatol Rehabil

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STRESZCZENIEWstęp. Ce lem pra cy by ła oce na wpły wu uszko dzeń zwią za nych z za awan so wa ną go nar tro zą oraz za bie gu en dopro te zo pla sty ki na zmia nę czu cia głę bo kie go i kon tro li sen so mo to rycz nej sta wu ko la no we go.Ma te riał i me to dy. Gru pę ba da ną sta no wi ły 62 oso by w śred nim wie ku 68,8 la ta, u któ rych prze pro wa dzo no zabieg en do pro te zo pla sty ki sta wu ko la no we go z po wo du go nar tro zy. Gru pa kon tro l na skła da ła się z 74 osób zdro wych, o śred niej wie ku 67,5 lat. Prze pro wa dzo no test czu cia po zy cji sta wu ko la no we go (JPS) w 45° zgię cia oraz au tor ski Test Kon tro li Sen so mo to rycz nej (TKS, oce nia ją cy spraw ność sen so mo to rycz ną w ska li od 0 do 5). W gru pie ba danej oce ny do ko na no trzy krot nie: przed za bie giem oraz 8 dni i 100 dni po ope ra cji. Ba da nie gru py kon tro l nej przepro wa dzo no jed no krot nie.Wy ni ki. Gru pa kon tro l na uzy ska ła w TKS wy nik śred ni 4,9, a w JPS śred ni wy nik 3,9º. W gru pie ba da nej uzyski wa no w ko lej nych ba da niach TKS wy ni ki śred nie: 3,1; 2,9 i 4,5 pkt. W te ście JPS gru pa ta uzy ska ła wy ni ki śred -nie: 10,5°, 9,5° oraz 3,9°, a w koń czy nie zdro wej 8,1°.Wnio ski. 1. Du że de fi cy ty pro prio cep cji i spraw no ści sen so mo to rycz nej ob ser wo wa ne w gru pie ba da nej mo gą przy czy niać się do szyb sze go roz wo ju zmian zwy rod nie nio wych i zwięk szać ry zy ko upad ku. 2. Wła sny test oce niają cy spraw ność sen so mo to rycz ną sta wu ko la no we go wy da je się być obiek tyw nym i kom plek so wym spo so bem oceny spraw no ści kon tro li sen so mo to rycz nej sta wu ko la no we go w tej gru pie cho rych. 3. Oce na do ko ny wa na za po mocą te stu wła sne go jest oce ną ja ko ścio wą i mo że mieć za sto so wa nie w kli nicz nej pra cy z pa cjen tem.Sło wa klu czo we: pro prio cep cja, en do pro te zo pla sty ka sta wu ko la no we go, cho ro ba zwy rod nie nio wa, sen so mo to ry ka SUMMARY Background. The study aimed to assess the impact of joint degeneration due to advanced gonarthrosis and the effect of arthroplasty on proprioception and sensorimotor system performance of the knee.Material and method. The arthroplasty group comprised 62 persons, aged 68.8 years on average, who underwent knee replacement due to gonarthrosis. The control group consisted of 74 healthy persons, with an average age of 67.5 years. The participants performed a test of Joint Position Sense (JPS) at 45° flexion and a Sensorimotor Control Test (SCT) designed by the authors to evaluate sensorimotor system performance (on a scale of 0-5). The arthroplasty group was assessed three times: before the knee replacement surgery, and then at 8 and 100 days after the surgery. The control group was assessed once.Results. The control group scored a mean of 4.9 in the SCT test and 3.9° in the JPS test. The mean scores upon consecutive measurements in the arthroplasty group were 3.1, 2.9 and 4.5 for the SCT test and 10.5°, 9.5° and 3.9°( compared to 8.1° for the healthy limb) for the JPS test.C...

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Section: Discussioncontrasting

confidence: 47%

Section: Wstępunclassified

Section: Introductionmentioning

confidence: 99%

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Impact of Knee Arthroplasty on Knee sensorimotor System Performance

Słupik¹,

Kowalski²,

Białoszewski³

2013

Ortop Traumatol Rehabil

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“…Although several observational studies have shown with reasonable consistency that knee extensor strength is an important determinant of physical function (4,9), evidence for the standing balance-physical function association is limited (4,5,7). In the first place, it is not a universal observation that patients with knee OA had greater standing COP displacements than did healthy controls (3,4,10). Furthermore, 3 cross-sectional studies (4,5,7) in patients with knee OA reported no significant association between standing balance and physical function in either bivariate or multivariable analyses.…”

Section: Introductionmentioning

confidence: 99%

Associations of knee extensor strength and standing balance with physical function in knee osteoarthritis

Pua

Liang

Ong

et al. 2011

Arthritis Care & Research

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Objective. Knee extensor strength is an important correlate of physical function in patients with knee osteoarthritis; however, it remains unclear whether standing balance is also a correlate. The purpose of this study was to evaluate the cross-sectional associations of knee extensor strength, standing balance, and their interaction with physical function. Methods. One hundred four older adults with end-stage knee osteoarthritis awaiting a total knee replacement (mean ؎ SD age 67 ؎ 8 years) participated. Isometric knee extensor strength was measured using an isokinetic dynamometer. Standing balance performance was measured by the center of pressure displacement during quiet standing on a balance board. Physical function was measured by the self-report Short Form 36 (SF-36) questionnaire and by the 10-meter fast-pace gait speed test. Results. After adjustment for demographic and knee pain variables, we detected significant knee strength by standing balance interaction terms for both SF-36 physical function and fast-pace gait speed. Interrogation of the interaction revealed that standing balance in the anteroposterior plane was positively related to physical function among patients with lower knee extensor strength. Conversely, among patients with higher knee extensor strength, the standing balancephysical function associations were, or tended to be, negative. Conclusion. These findings suggest that although standing balance was related to physical function in patients with knee osteoarthritis, this relationship was complex and dependent on knee extensor strength level. These results are of importance in developing intervention strategies and refining theoretical models, but they call for further study.

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Knee biomechanics early after knee replacement surgery predict abnormal gait patterns 12 months postoperatively

Levinger

Menz

Morrow

et al. 2011

Journal Orthopaedic Research

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An abnormal flexor moment pattern is often evident following total knee replacement (TKR) surgery. We investigated whether such a pattern at 12 months post-surgery could be predicted using biomechanical gait measures assessed before surgery and at 4 months post-surgery. Thirty two TKR patients were evaluated and classified as normal (biphasic pattern) or abnormal (flexor moment pattern) at each time point. Biomechanical parameters collected before surgery and at 4 months post-surgery were then explored for their ability to predict gait patterns at 12 months post-surgery. The gait pattern at 4 months was significantly associated with the 12 month post-surgery gait pattern, with over half of those with a flexor moment pattern at 4 months retaining this pattern at 12 months. Discriminant function analysis indicated that peak knee flexion during early stance, peak knee extension, and peak knee extension moment at 4 months post-surgery were independent predictors of the gait pattern at 12 months. Thus, an abnormal knee flexor moment pattern at 12 months post-surgery can be predicted by biomechanical analysis 4 months after surgery. Therefore, interventions aimed at improving active extension may need to be implemented early after surgery to restore a normal gait pattern.

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Physiological risk factors for falls in people with knee osteoarthritis before and early after knee replacement surgery

Cited by 132 publications

References 54 publications

Impact of Knee Arthroplasty on Knee sensorimotor System Performance

Impact of Knee Arthroplasty on Knee sensorimotor System Performance

Associations of knee extensor strength and standing balance with physical function in knee osteoarthritis

Knee biomechanics early after knee replacement surgery predict abnormal gait patterns 12 months postoperatively

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