Postural Stability in Patients with Knee Osteoarthritis: Comparison with Controls and Evaluation of Relationships between International Classification of Functioning, Disability, and Health

Publication year: 2012
Source:Archives of Physical Medicine and Rehabilitation

Ru-Lan Hsieh, Wen-Chung Lee, Min-Tzu Lo, Wei-Cheng Liao

Objective To assess the differences of postural stability between patients with knee osteoarthritis and controls without knee osteoarthritis and to evaluate possible relationships between International Classification of Functioning, Disability, and Health (ICF). Design An age-matched, case-controlled trial with a cross-sectional design. Setting A teaching hospital. Participants Seventy-three patients with knee osteoarthritis and 60 age-matched controls. Interventions Data on patients' postural stability and additional health-related variables were collected using various instruments. These included the Hospital Anxiety and Depression Scale, the Multidimensional Fatigue Inventory, the World Health Organization Quality of Life Brief Version, the physical function test (chair-rising time), the Chinese version of the Western Ontario and McMaster University Osteoarthritis Index, the Chinese version of the Knee Injury and Osteoarthritis Outcome Score, and the Biodex Stability System. Main Outcome Measures A comparison of postural stability in patients with knee osteoarthritis versus that of controls was performed. The relationship between postural stability scores for patients with knee osteoarthritis and ICF components was evaluated. Pearson correlation tests were used to determine the variables that correlated with postural stability among these patients. Results Patients with knee osteoarthritis displayed lower overall postural stability than controls (scores of 0.7 vs. 0.5, P=.006) and scored lower on the environmental domain of the WHOQOL-BREF (62.2 vs. 66.8, P=.014). For patients with knee osteoarthritis, postural stability was weakly associated with the ICF components of body functions and structures, including pain (r=0.33 to 0.34, P=.004), physical fatigue (r=0.28, P=.016), and reduced motivation (r=0.30, P=.011). Weak to moderate associations between postural stability and the ICF components of activities and participation were found; the relevant ICF variables included reduced activity (r=0.38, P=.001), physical domain and function (r=0.34 to 0.48, P=.001 to P < .004), activities of daily living (r=0.51, P < .001), and sports and recreation (r=0.35, P=.003). A moderate association between postural stability and the ICF components of personal and environmental factors was observed, including age (r=0.52, P < .001) and quality of life (r=0.4, P=.001). Conclusions Patients with knee osteoarthritis displayed lower postural stability and achieved lower scores in the environmental domain of quality of life measures compared with controls. The postural stability of patients with knee osteoarthritis was weakly to moderately associated with the following ICF components: body functions and structures, activities and participation, and personal and environmental factors.

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