Background Severe knee osteoarthritis (OA) is characterized by stiffness, pain, and disability of the knee joint. Severe pain negatively affects muscle strength, coordination, postural stability, proprioception, mobility, and increases fall risk and possibly fear of falling. Individuals with severe knee OA experience loss of self-efficacy, activity avoidance, loss of self-confidence, and finally fear of falling without actually experiencing a fall (1). Despite the high prevalence of falls in patients with OA, few studies have investigated fear of falling in patients with knee OA (2).
Objectives The present study was conducted to determine the risk factors affecting fear of falling and to investigate the relationship between fear of falling and age, gender, body mass index, pain level, range of motion, muscle strength, knee swelling, postural stability, and functional status in patients with knee OA.
The purpose of our study was to evaluate the regression of fear of falling and identify its risk factors in patients with severe knee OA.
Methods A total of 71 patients who were diagnosed with knee OA according to the American College of Rheumatology (ACR) and who were accepted as stage 2 and 3 based on the Kellgren-Lawrence criteria, were included in the study.
Outcome measures included fear of falling, pain intensity, and range of motion, quadriceps and hamstring muscle strength, knee swelling, postural stability, and functional status.
Pearson correlation and multiple logistic regression test was used to determine the risk factors of fear of falling and relationships between fear of falling and age, body mass index, pain intensity, range of motion, muscle strength, knee swelling, postural stability, and functional status.
Results Multiple logistic regression analysis showed that age (odds ratio=12.5, p=0.011), body mass index (odds ratio=14.5, p=0.030), pain intensity (odds ratio=3.5, p=0.045), range of motion (odds ratio=9.8, p=0.012), and knee swelling (odds ratio=8.4, p=0.019) were independent risk factors for fear of falling among patients with knee OA.
Conclusions We conclude that age, body mass index, pain intensity, range of motion and knee swelling influence the fear of falling. They are viewed as an important predictor of fear of falling in knee OA. Our results could be used to help select knee OA patients who should be enrolled in fall prevention programmes.
Tsonga T, Michalopoulou M, Kapetanakis S, et al. Risk factors for fear of falling in elderly patients with severe knee osteoarthritis before and one year after total knee arthroplasty. J Orthop Surg (Hong Kong). 2016 Dec;24(3):302–306.
Levinger P, Menz HB, Wee E, Feller JA, Bartlett JR, Bergman NR. Physiological risk factors for falls in people with knee osteoarthritis before and early after knee replacement surgery. Knee Surg Sports Traumatol Arthrosc. 2011 Jul;19(7):1082–9.
Disclosure of Interest None declared