Relationship between fall history and toe grip strength in older adults with knee osteoarthritis in Japan: A cross-sectional study

Abstract

Background Knee osteoarthritis (KOA), one of the most common musculoskeletal diseases in older adults, is associated with a high incidence of falls. Similarly, toe grip strength (TGS) is associated with a history of falls in older adults; however, the relationship between TGS and falls in older adults with KOA who are at risk of falling is not known. Therefore, this study aimed to determine if TGS is associated with a history of falls in older adults with KOA. Methods The study participants, older adults with KOA scheduled to undergo unilateral total knee arthroplasty (TKA), were divided into two groups: non-fall (n = 256) and fall groups (n = 74). Descriptive data, fall-related assessments, modified Fall Efficacy Scale (mFES), radiographic data, pain, and physical function including TGS were evaluated. The assessment was conducted on the day before performing TKA. Mann–Whitney and chi-squared tests were performed to compare the two groups. Multiple logistic regression analysis was performed to determine the association of each outcome with the presence or absence of falls. Results Mann-Whitney U test revealed that the fall group had statistically significantly lower height, TGS on the affected and unaffected sides, and mFES. Multiple logistic regression analysis revealed that the incidence of fall history is associated with TGS on the affected side; the weaker the affected TGS of the KOA, the more likely the individual is to fall. Conclusions Our results indicate that TGS on the affected side is related to a history of falls in older adults with KOA. The significance of evaluating TGS among patients with KOA in routine clinical practice was demonstrated.

Association between postoperative fall history and toe grip strength in patients after total knee arthroplasty: A prospective observational study

“…Considering the study by Mawarikado et al. [ 19 ], we can surmise that preoperative falls were influenced by preoperative TGS, whereas postoperative falls were influenced by postoperative TGS. As such, we believe that the impact of TGS on perioperative falls in TKA patients cannot be examined longitudinally; instead, TGS must be evaluated before and after surgery to determine the risk for pre‐ and postoperative fall events, respectively.…”

“…This study takes the first step in demonstrating the significance of evaluating TGS to determine the risk for falls after TKA. Considering our findings suggesting that TGS affects falls before [ 19 ] and after TKA, the next step would be to determine how TGS training affects falls.…”

“…identified TGS as an independent factor associated with knee osteoarthritis [ 18 ], as well as a relevant factor for falls among older adults. We also reported that TGS is associated with a history of falls in patients with knee osteoarthritis prior to TKA [ 19 ].…”

Mitochondrial Oxidative Stress Regulates FOXP3+ T-Cell Activity and CD4-Mediated Inflammation in Older Adults with Frailty

“…Notably, frailty often presents as a dysregulated immune response, exacerbating physical vulnerabilities such as diminished grip strength, an increased risk of falls, and a reduced healthy lifespan in older adults [ 7 , 8 , 9 , 10 , 11 ]. The dysregulation of CD4 + T cells has been shown to aggravate chronic proinflammatory cytokine production during aging [ 12 , 13 , 14 , 15 ].…”

Toe grip strength training improves gait performance and prevents falls in patients after total knee arthroplasty

“…Toe grip strength (TGS) has recently gained interest, as previous reports have shown that TGS affects falls in patients with knee osteoarthritis (KOA) 7 . Tsuyuguchi et al 8 reported that nursing home residents who received TGS training showed significant improvements in TGS and fall risk scores.…”