Influence of hip and knee osteoarthritis on dynamic postural control parameters among older fallers

OBJECTIVE: To compare the relationship between postural control and knee and hip osteoarthritis in older adults with and without a history of falls.
METHODS: Fallers were those with ≥ 2 falls or 1 injurious fall over 12 months. Non-fallers were volunteers with no falls in the past year. Radiological evidence of osteoarthritis with no reported symptoms was considered "asymptomatic osteoarthritis", while "symptomatic osteoarthritis" was defined as radiographic osteoarthritis with pain or stiffness. Dynamic postural control was quantified with the limits of stability test measured on a balance platform (Neurocom® Balancemaster, California, USA). Parameters assessed were end-point excursion, maximal excursion, and directional control.
RESULTS: A total of 102 older individuals, mean age 73 years (standard deviation 5.7) years were included. The association between falls and poor performance in maximal excursion and directional control was confounded by age and comorbidities. In the same linear equation model with falls, symptomatic osteoarthritis remained independently associated with poor end-point excursion (β-coefficient (95% confidence interval) -6.80 (-12.14 to -1.42)).
CONCLUSION: Poor performance in dynamic postural control (maximal excursion and directional control) among fallers was not accounted for by hip/knee osteoarthritis, but was confounded by old age and comorbidities. Loss of postural control due to hip/knee osteoarthritis is not a risk factor for falls among community-dwelling older adults.
Study site: Departments of Emergency Medicine, Primary Care and Geriatric Medicine, in a teaching hospital in Kuala Lumpur, Malaysia