Predictors of single-leg standing balance in individuals with medial knee osteoarthritis

Authors

  • Michael A. Hunt,

    Corresponding author
    1. Centre for Health, Exercise and Sports Medicine, Melbourne Physiotherapy School, University of Melbourne, Melbourne, Australia
    2. University of British Columbia, Vancouver, British Columbia, Canada
    • Department of Physical Therapy, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, British Columbia, Canada V6T 1Z3
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  • Fiona J. McManus,

    1. Centre for Health, Exercise and Sports Medicine, Melbourne Physiotherapy School, University of Melbourne, Melbourne, Australia
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  • Rana S. Hinman,

    1. Centre for Health, Exercise and Sports Medicine, Melbourne Physiotherapy School, University of Melbourne, Melbourne, Australia
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  • Kim L. Bennell

    1. Centre for Health, Exercise and Sports Medicine, Melbourne Physiotherapy School, University of Melbourne, Melbourne, Australia
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    • Dr. Bennell has received consultant fees, speaking fees, and/or honoraria (less than $10,000) from the Australian Physiotherapy Association.


Abstract

Objective

To identify factors related to single-leg standing balance in individuals with medial compartment knee osteoarthritis (OA).

Methods

This cross-sectional study assessed clinical, demographic, and biomechanical measures in 57 individuals and their relationships with single-leg standing balance. Differences in age, mass, symptoms, knee pain, radiographic severity, lower extremity alignment, and hip and knee extension as well as hip abduction torques were compared between those who could and could not perform 3 trials of single-leg standing balance. Multiple regression was used to identify predictors of center of pressure (COP) path length in those who could complete the task.

Results

Thirty-four individuals (60%) successfully completed all 3 single-leg standing balance trials and were significantly younger (P = 0.003) than those who could not. No other variable was significantly different between the groups. Disease severity, number of painful knees, lower extremity alignment, pain intensity, and quadriceps torque were all significant predictors of COP path length. Specifically, better single-leg standing balance (smaller COP path length) was related to more severe radiographic changes and stronger quadriceps, those with bilateral symptoms, and to less varus malalignment and knee pain.

Conclusion

Single-leg standing balance in those with medial knee OA is related to the modifiable factors lower extremity alignment, knee pain, and quadriceps strength. Given the reduced balancing ability in this patient population, interventions targeting these factors are necessary.

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