Background

Individuals with osteoarthritis fall at a greater rate than the general population, likely as a result of weakness, pain, movement limitations, and a decline in balance. Due to the high prevalence of osteoarthritis in the population, understanding the mechanisms leading to greater fall risk is an important issue to better understand.

Research question

What is the influence of unilateral knee osteoarthritis on the characteristics of performing a voluntary step (i.e., similar to that performed to avoid a fall after a perturbation), compared to healthy age-matched controls?

Methods

Case-control study performed in a Health maintenance organization physical therapy clinic. The research group consisted of a referred sample of 21 patients with unilateral knee osteoarthritis. The control group consisted of 22 age-matched healthy individuals. All participants were over 65 years of age. Participants were excluded if they had a surgical procedure to back or lower limb within one year before testing, oncological or neurological disease or a deficit in tactile sense. Movements were performed with and without dual tasking.

Measurements

Duration of the initiation phase (cue to step initiation), preparatory phase (step initiation to foot off) and swing phase (foot off to foot contact).

Results

In the preparatory phase and swing phase, the osteoarthritis group moved more slowly than the control group, and these differences were larger for forward compared to backward movements. Dual-tasking slowed responses in the pre-movement initiation stage across groups.

Significance

The differences in basic parameters, and the slower movements in the osteoarthritis group, are consistent with known features of osteoarthritis, being a disease commonly regarded as primarily "mechanical", and are likely to increase fall risk. These response deficits suggest we should take advantage of advanced rehabilitation techniques, including cognitive loading, to help prevent falls in older adults with osteoarthritis.

中文翻译：

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膝关节骨关节炎患者的自愿步骤执行：有症状的腿和无症状的腿

背景

骨关节炎患者的跌幅高于普通人群，这可能是由于虚弱，疼痛，运动受限和平衡能力下降造成的。由于人群中骨关节炎的患病率很高，因此了解导致更大跌倒风险的机制是一个更好理解的重要问题。

研究问题

与健康的年龄相匹配的对照组相比，单侧膝关节骨关节炎对执行自愿性步骤的特征（即类似于避免摄动后跌倒的特征）有什么影响？

方法

在健康维护组织物理治疗诊所进行的病例对照研究。该研究小组由21名单侧膝关节骨关节炎患者的参考样本组成。对照组由22名年龄匹配的健康个体组成。所有参与者均超过65岁。如果参加者在测试前一年内进行了手术以支持背部或下肢，肿瘤或神经系统疾病或触觉不足，则将其排除在外。运动在有和没有双重任务的情况下进行。

测量

初始阶段（由于逐步启动而导致），准备阶段（逐步开始至脚踩）和摆动阶段（使脚脱离脚接触）的持续时间。

结果

在准备阶段和摆动阶段，骨关节炎组的运动比对照组慢，与向前运动相比，向后运动的差异更大。在团队之间的运动前启动阶段，双重任务减缓了响应速度。

意义

基本参数的差异以及骨关节炎组的运动缓慢与骨关节炎的已知特征相一致，骨关节炎是一种通常被认为主要是“机械性”的疾病，并有可能增加跌倒的风险。这些反应不足提示我们应该利用先进的康复技术，包括认知负荷，来帮助预防患有骨关节炎的老年人跌倒。