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

Abstract

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

Physical and Psychological Factors Affecting Falls in Older Patients with Arthritis

“…The prevalence of RA in South Korea estimates was 0.27% in 2008 [24]. Interestingly, contrary to previous results regarding the relevance of falls and arthritis, there have been different opinions from some experts [25,26]. Some OA studies reported no association between knee pain and a fall, and they even suggested that pain was protective against falls [27][28][29][30].…”

Impact of Knee Pain on Fear of Falling, Changes in Instrumental Activities of Daily Living, and Falls Among Malaysians Age 55 Years and Above

“…Few studies have obtained data on fall occurrence prospectively in relationship to knee pain ( 18 ). A study by Dore et al suggested that the presence of lower limb OA in one site led to a 53% increase the risk of future falls in 12 months ( 19 ).…”

Effects of tai chi on postural control during dual-task stair negotiation in knee osteoarthritis: a randomised controlled trial protocol

“…During stair climbing or descent, people with KOA both have altered kinematics changes in sagittal plane and delayed quadriceps muscle activity 4 5. Impaired postural control and balance, reduced knee muscle strength, poor proprioceptive acuity and joint symptoms have been postulated to elevate fall risks in this population 6 7. Therapeutic strategies addressing these potential underlying neuromechanical factors have been advocated to prevent falls 7 8…”

“…Impaired postural control and balance, reduced knee muscle strength, poor proprioceptive acuity and joint symptoms have been postulated to elevate fall risks in this population 6 7. Therapeutic strategies addressing these potential underlying neuromechanical factors have been advocated to prevent falls 7 8…”