Postural Stability and Proprioception Abnormalities in Patients with Knee Osteoarthritis

Abstract

Knee osteoarthritis (OA) leads to the damage of all joint components, with consequent proprioceptive impairment leading to a decline in balance and an increase in the risk of falls. This study was aimed at assessing postural stability and proprioception in patients with knee OA, and the relation between the impairment in postural stability and proprioception with the severity of OA and functional performance. Thirty-eight patients with knee OA were recruited. OA severity was classified with the Kellgren–Lawrence score. Postural stability and proprioception were assessed in double- and single-limb stance, in open- and closed-eyes with an instrumented device. Functional performance was assessed using the Knee Score Society (KSS) and the Short Performance Physical Battery (SPPB). Relationships between variables were analyzed. Postural stability was reduced with respect to reference values in double-limb stance tests in all knee OA patients, while in single-stance only in females. Radiological OA severity, KSS-Functional score and SPPB were correlated with greater postural stability impairments in single-stance. Knee OA patients show decreased functional abilities and postural stability impairments. Proprioception seems to be impaired mostly in females. In conclusion, clinical management of patients with OA should include an ongoing assessment and training of proprioception and postural stability during rehabilitation.

Investigating Knee Joint Proprioception and Its Impact on Limits of Stability Using Dynamic Posturography in Individuals with Bilateral Knee Osteoarthritis—A Cross-Sectional Study of Comparisons and Correlations

“…This study's findings, which show substantial proprioceptive impairment in terms of increased JPE in the KOA group, are in accordance with findings from previously published papers that involve subjects with other types of knee condition [37,38]. Degenerative changes or atrophy that weaken muscles can damage joint structures, affect mechanoreceptors and proprioceptive afferent input to the higher centers, and compromise knee proprioception, which are a few potential causes of decreased proprioception in KOA patients [10,39,40]. Proprioception and the intricate afferent performance of the proprioceptive network system are affected by pain and edema in KOA patients [10,40].…”

“…Alshahrani et al [10] showed that the magnitude of knee JPE was larger in individuals with KOA compared to asymptomatic groups in sitting positions (20° of flexion: d = 1.73, p < 0.001; 40° of flexion: d = 1.72, p < 0.001; 60° of flexion: d = 1.83, p < 0.001) and standing positions (20° of flexion: d = 1.89, p < 0.001). The mean knee JPE in our study ranged from 5.4° to 5.8°, which is the average error shown for KOA in different studies [10,11,[40][41][42].…”

“…Proprioception and the intricate afferent performance of the proprioceptive network system are affected by pain and edema in KOA patients. [10,40]. Alshahrani et al [10] showed that the magnitude of knee JPE was larger in individuals with KOA compared to asymptomatic groups in sitting positions (20° of flexion: d = 1.73, p < 0.001; 40° of flexion: d = 1.72, p < 0.001; 60° of flexion: d = 1.83, p < 0.001) and standing positions (20° of flexion: d = 1.89, p < 0.001).…”

“…Degenerative changes or atrophy that weaken muscles can damage joint structures, affect mechanoreceptors and proprioceptive afferent input to the higher centers, and compromise knee proprioception, which are a few potential causes of decreased proprioception in KOA patients [10,39,40]. Proprioception and the intricate afferent performance of the proprioceptive network system are affected by pain and edema in KOA patients [10,40]. Alshahrani et al [10] showed that the magnitude of knee JPE was larger in individuals with KOA compared to asymptomatic groups in sitting positions (20 • The mean knee JPE in our study ranged from 5.4 • to 5.8 • , which is the average error shown for KOA in different studies [10,11,[40][41][42].…”

Does adding neuromuscular electrical stimulation to rehabilitation following total knee arthroplasty lead to a better quadriceps muscle strength recovery? A systematic review

“…In fact, in both groups, there was a significant quadriceps strength increase, and strength was significantly higher than that in the controls up to 12 months after surgery. This means that NMES can be used as a valid option when it is not possible to perform traditional strength training, as, for example, immediately postsurgery when the recovery of muscle strength may have positive effects for rehabilitation as a whole [20,21]. It has been reported that the early recovery of muscle strength following TKA is positively related to general functional outcome and performance [22].…”