Muscular function and functional mobility of faller and non-faller elderly women with osteoarthritis of the knee

Abstract

Falls are a major concern in the elderly population with chronic joint disease. To compare muscular function and functional mobility among older women with knee osteoarthritis with and without a history of falls, 15 elderly women with a history of falls (74.20 ± 4.46 years) and 15 without a history of falls (71.73 ± 4.73 years) were studied. Muscular function, at the angular speed of 60, 120, and 180º/s, was evaluated using the Biodex Isokinetic Dynamometer. The sit-to-stand task was performed using the Balance Master System and the Timed Up and Go test was used to determine functional mobility. After collection of these data, the history of falls was investigated. A statistically significant difference was detected in the time taken to transfer the center of gravity during the sit-to-stand test (means ± SD; non-fallers: 0.35 ± 0.16 s; fallers: 0.55 ± 0.32 s; P = 0.049, Student ttest) and in the Timed Up and Go test (medians; non-fallers: 10.08 s; fallers: 11.59 s; P = 0.038, Mann-Whitney U-test). The results indicated that elderly osteoarthritic women with a history of falls presented altered functional mobility and needed more time to transfer the center of gravity in the sit-to-stand test. It is important to implement strategies to guarantee a better functional performance of elderly patients to reduce fall risks.

Is the History of Falls an Indicative of Greater Decline in Quadriceps Muscle Function and Postural Sway?

“…Alencar et al 26 found that the speed of the STS movement infl uence s the vertical component of the center of gravity. The results revealed a relationship between muscular power and displacement of COP in the AP direction.…”

“…[17][18][19] A bility to keep postural control is important for performing not only functional activities such as standing up or sitting down but also coordinated voluntary movements that are crucial in activities of daily living. 26 The STS test is easy to apply and it is one of the most widely used methods to assess the functional muscular strength as well as the balance and functional mobility of elderly people, 27 thus allowing identifi cation of those individuals with impaired balance. 1 It has been suggested that the history of fall could be used as a sign of postural control system defi cits.…”

Backward disequilibrium in elderly subjects

“…Indeed, balance controlis a complex sensori-motor function which requires the integration of vestibular, visual, and somesthetic information into the central nervous system (pyramidal, extrapyramidal, and cerebellar systems) in order to maintain antigravitar postures and to produce a suitable response to any balance perturbation (Horak and McPherson 1996). In addition, the quality of muscle and joints is important in the balance function (Alencar et al 2007). …”

Correlation between Postural Stability and Functional Mobility in Patients with Knee Osteoarthritis

“…The knee OA associated with the presence of fall may cause worse functional mobility. 7 In 2008, Shaheen et al 8 published that patients with knee OA have a worse balance, both static and dynamic, and also worse functional mobility. The impairment of balance is also associated with pain suffered by the patients.…”