Citation

Hatfield GL, Morrison A, Wenman M, Hammond C, Hunt MA. Phys. Ther. 2015; 96(3): 324-337.

Affiliation

G.L. Hatfield, PT, PhD, Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.

Copyright

(Copyright © 2015, American Physical Therapy Association)

DOI

10.2522/ptj.20150025

PMID

26183586

Abstract

BACKGROUND: People with knee osteoarthritis (OA) have a high prevalence of falls. Poor standing balance is one risk factor, but the extent of standing balance deficits in those with knee OA is unknown.

PURPOSE: Summarize available data on standing balance in people with knee OA compared to people without, and across disease severity. DATA SOURCES: Medline, Embase, CINAHL, Web of Science through November 19, 2014. STUDY SELECTION: Studies on individuals with knee OA containing clinical, quantifiable measures of standing balance were included.

METHODological quality was assessed by two reviewers using a 16-item quality index developed for non-randomized studies. Studies scoring >50% on the index were included. DATA EXTRACTION: Participant characteristics (age, sex, body mass index, OA severity, compartment, unilateral/bilateral) and balance outcomes were extracted by two reviewers. Standardized mean differences were pooled using a random-effects model. DATA SYNTHESIS: The search yielded 2715 papers; eight met selection and quality assessment criteria. Median score on the quality index was 13/17. People with knee OA consistently performed worse than healthy controls on the Step Test, Single Leg Stance Test, Functional Reach Test, Tandem Stance Test, and Community Balance and Mobility Scale. The pooled standardized mean difference was -1.64 [-2.58 to -0.69]. No differences were observed between varying degrees of malalignment, or between unilateral versus bilateral disease. LIMITATIONS: No studies compared between knee OA severities. Thus, expected changes in balance as the disease progresses remain unknown.

CONCLUSIONS: Few studies compared knee OA to healthy controls, but those that did found that people with knee OA performed significantly worse. More research is needed to understand the extent of balance impairments in knee OA using easy-to-administer, clinically-available tests.

Language: en