Title: Relationship Between Proprioception and Dynamic Balance in Knee Osteoarthritis
Authors: Sara Awad*, Khaled Ayad
DOI: http://dx.doi.org/10.18535/jmscr/v4i6.60
Background/Aim: Knee Osteoarthritis (OA) is a highly recognized cause for chronic disability in elders. Patients with knee OA show impairment of dynamic balance and high risk of falls. Poor proprioception was also identified in knee osteoarthritic population and was related to increased risk of falling. The findings of studies conducted to correlate between dynamic balance and proprioception in these patients are conflicting. The aim of this study was to find if there is a relationship between dynamic balance and proprioception (sense of position and sense of movement) in patients with knee OA. Subjects and Methods: Thirty nine female patients with knee Osteoarthritis grade II and III Kellgren and Lawrence (KL) scale, aged from 40 to 65 years old were included in the study. Biodex Balance System (BBS) was used to evaluate dynamic balance and retrieve three outcome measures: Overall stability Index (OSI), Mediolateral Stability Index (MLSI) and Anteroposterior Stability Index (APSI). Proprioception was measured through Biodex system 3 isokinetic dynamometer in which knee joint reposition task and the threshold to detection of passive motion (TTDPM) were used to assess the sense of position and the sense of movement respectively. Results: Pearson correlation coefficient was used. There was nonsignificant correlation between proprioception and dynamic balance (P ˃ 0.05).However, there was a significant correlation between the sense of position and sense of movement (P ˂ 0.05). Conclusion: There is no relationship between decreased proprioception and impaired dynamic balance in patients with knee OA. Key words: Osteoarthritis –dynamic balance -proprioception. 1. Loeser R F. Age-related changes in the musculoskeletal system and the development of arthritis. Clin. Geriatr. Med. 2010; 26: 371–386. 2. Petrella M, Neves T M, Reis J G, Gomes M M, Oliveira R D. Postural control parameters in elderly female fallers and non-fallers diagnosed or not with knee osteoarthritis. RevistaBrasileira de Reumatologia, 2012; 52: 512–517. 3. Khalaj N, Abu Osman N A, Mokhtar A H, Mehdikhani M, Wan Abas W. B. Balance and risk of fall in individuals with bilateral mild and moderate knee osteoarthritis. PloS One, 2014; 9(3): e92270. 4. Takacs J, Carpenter M G, Garland S J, Hunt MA. The role of neuromuscular changes in aging and knee osteoarthritis on dynamic postural control. Aging and Disease, 2013; 4(2): 84–99. 5. GarsdenL R, Bullock-Saxton J E. Joint reposition sense in subjects with unilateral osteoarthritis of the knee. Clinical Rehabilitation, 1999; 13(2): 148–155. 6. Koralewicz L M, &Engh G A. Comparison of proprioception in arthritic and age-matched normal knees. The Journal of Bone and Joint Surgery. American Volume, 2000; 82(11): 1582–1588. 7. Lord S R, Ward J A, Williams P, Anstey K J. Physiological factors associated with falls in older community-dwelling women. J Am GeriatrSoc, 1994; 42:1110-7. 8. Arnold B L, Schmitz R J.Examination of balance measures produced by the biodex stability system. Journal of Athletic Training, 1998; 33: 323–327. 9. Drouin J M, Valovich T C, Shultz S J, Gansneder B M, Perrin D H. Reliability and validity of the biodexsystem 3 pro isokinetic dynamometer velocity, torque and position measurements. European Journal of Applied Physiology, 2004; 91:22-29. 10. Peixoto J G, Dias J M D, Dias R C, Fonseca S T D, Teixeira-Salmela L F. Relationships between measures of muscular performance, proprioceptive acuity, and aging in elderly women with knee osteoarthritis. Archives of Gerontology and Geriatrics, 2011; 53(2): 253–257. 11. Riemann B L, Myers J B, Lephart S M. Sensorimotor system measurement techniques. Journal of Athletic Training, 2002; 37(1): 85–98. 12. Takacs J, Carpenter M G, Garland S J, Michael A. Factors associated with dynamic balance in people with knee osteoarthritis. Archivesofphysical medicineand rehabilitation, 2015;doi: 10.1016/j.apmr.2015.06.014. 13. Duman I, Taskaynatan M A, Mohur H, Tan A K. Assessment of the impact of proprioceptive exercises on balance and proprioception in patients with advanced knee osteoarthritis. RheumatolInt, 2012; 32:3793–3798.Abstract
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