Level Of Locomotive Risk Syndrome And Risk Of Fall In Patients With Knee Osteoarthritis And Its Comparison With Healthy Elderly Population

Level Of Locomotive Risk Syndrome and Risk of Fall

Abstract

Knee osteoarthritis (OA) is a common condition that greatly affects mobility, but mobility is also reduced with aging due to multiple factors including muscular weakness, joint stiffness, balance issues, and inactivity. Methods: In a comparative cross-sectional study conducted at the Railway General Hospital Rawalpindi spanning from July to December 2018 a total of two hundred patients aged between 65 and 75 years were recruited using a non-probability convenience sampling technique. Patients clinically diagnosed with knee osteoarthritis with grades II or III according to the Kallgren and Lawrence classification were included while those with other forms of arthritis a history of knee surgery, lower limb arthroplasty, or any musculoskeletal or neurological impairments affecting balance were excluded. The healthy elderly group had inclusion criteria of the absence of arthritis and exclusion criteria for lower limb deformities or other musculoskeletal and neurological impairments. Locomotive syndrome assessment involved The Stand-Up Test, Two-Step Test, and Geriatric Locomotive Function Scale-25 Questionnaire. Fall risk was evaluated through the Time Up and Go Test, Five Times Sit to Stand Test, and investigation about walking difficulty, road crossing, standing on a single leg, and fall history. Data was analysed using SPSS version 21 employing the Mann-Whitney U-test due to deviation of data from normal distribution. Results: The study population had a mean age of 68.05±5.44 years. The locomotive syndrome Risk Level test, TUG, FTSST, difficulty in stair climbing, difficulty in continuous walking, and difficulty in road crossing all showed statistical significance with p < 0.05. However, the p-value for fall on the floor was greater than 0.24. Conclusion: Patients with knee osteoarthritis exhibit a higher locomotive syndrome risk level, increased fall risk, and greater difficulty in stair climbing, continuous walking, and road crossing when compared to the healthy elderly population.

1. Kim Y, Suehara Y, Ishii M, Kawasaki T, Matsuoka K, Okubo T, et al. A comparative study of 2 screening tools for locomotive syndrome (The “Loco-check” and the “GLFS-25”): An orthopedic outpatient-based survey. British Journal of Medicine and Medical Research. 2016;17(5):1-13.
2. Kusumaningtyas M, Tamtomo D, Murti B. Factors associated with the occurrence of osteoarthritis: a path analysis evidence from Surakarta, Central Java. Journal of Epidemiology and Public Health. 2019;4(1):9-19.
3. Ivanenko YP, Cappellini G, Dominici N, Poppele RE, Lacquaniti F. Coordination of locomotion with voluntary movements in humans. Journal of Neuroscience. 2005;25(31):7238-53.
4. Yoshimura N, Muraki S, Oka H, Tanaka S, Ogata T, Kawaguchi H, et al. Association between new indices in the locomotive syndrome risk test and decline in mobility: third survey of the ROAD study. Journal of orthopaedic science. 2015;20(5):896-905.
5. Silverwood V, Blagojevic-Bucknall M, Jinks C, Jordan J, Protheroe J, Jordan K. Current evidence on risk factors for knee osteoarthritis in older adults: a systematic review and meta-analysis. Osteoarthritis and cartilage. 2015;23(4):507-15.
6. Ishijima M, Kaneko H, Hada S, Kinoshita M, Sadatsuki R, Liu L, et al. Osteoarthritis as a cause of locomotive syndrome: its influence on functional mobility and activities of daily living. Clinical Reviews in Bone and Mineral Metabolism. 2016;14(2):77-104.
7. Stergiou N. Nonlinear analysis for human movement variability: CRC press; 2018.
8. Patel AH, Arora AM, Patel NJ, Patel HG, Mansuri MM. ASSESSMENT OF LOCOMOTIVE SYNDROME: A PROSPECTIVE, OBSERVATIONAL STUDY IN COMMUNITIES OF GANDHINAGAR AND AHMEDABAD. 2017.
9. Misbah S, Kadir E, Roshan R, Khan IA, ur Rahman M. GERIATRIC PROBLEMS AWARENESS AMONG ADULTS IN RAWALPINDI. Pakistan Armed Forces Medical Journal. 2015(6):743.
10. Iwaya T, Doi T, Seichi A, Hoshino Y, Ogata T, Akai M. Characteristics of disability in activity of daily living in elderly people associated with locomotive disorders. BMC geriatrics. 2017;17(1):165.
11. Seichi A, Hoshino Y, Doi T, Akai M, Tobimatsu Y, Iwaya T. Development of a screening tool for risk of locomotive syndrome in the elderly: the 25-question Geriatric Locomotive Function Scale. Journal of Orthopaedic Science. 2012;17(2):163-72.
12. Matsumoto H, Hagino H, Wada T, Kobayashi E. Locomotive syndrome presents a risk for falls and fractures in the elderly Japanese population. Osteoporosis and sarcopenia. 2016;2(3):156-63.
13. Makizako H, Shimada H, Doi T, Tsutsumimoto K, Nakakubo S, Hotta R, et al. Predictive cutoff values of the five-times sit-to-stand test and the timed “up & go” test for disability incidence in older people dwelling in the community. Physical therapy. 2017;97(4):417-24.
14. Muramoto A, Imagama S, Ito Z, Hirano K, Ishiguro N, Hasegawa Y. Physical performance tests are useful for evaluating and monitoring the severity of locomotive syndrome. Journal of Orthopaedic Science. 2012;17(6):782-8.
15. Whitney SL, Wrisley DM, Marchetti GF, Gee MA, Redfern MS, Furman JM. Clinical measurement of sit-to-stand performance in people with balance disorders: validity of data for the Five-Times-Sit-to-Stand Test. Physical therapy. 2005;85(10):1034-45.
16. Ohsawa T, Yanagisawa S, Shiozawa H, Omodaka T, Saito K, Kitagawa T, et al. Relationship between knee osteoarthritis and the locomotive syndrome risk tests: a cross-sectional study. Journal of Orthopaedic Science. 2016;21(4):512-6.
17. Safaz I, Turk H, Yasar E, Alaca R, Tok F, Tugcu I. Gulhane Medical Journal. 2015;57(null):142.
18. Goldberg A, Chavis M, Watkins J, Wilson T. The five-times-sit-to-stand test: validity, reliability and detectable change in older females. Aging clinical and experimental research. 2012;24(4):339-44.