Factors associated with balance function in patients with knee osteoarthritis: An integrative review.
Congying Liu, Qiaoqin Wan, Weijiao Zhou and 2 others
PMID 31406784WHAT IT FOUND
In knee osteoarthritis, older age, higher BMI, greater pain, and weaker knees or ankles were linked to poorer balance.
Knee sleeves and insoles gave mixed results. Weight loss and strengthening were suggested, but this review cannot prove they improve balance.
Key findings
01Age was negatively associated with balance function in four studies, BMI was inversely related in two studies, and knee pain was negatively related in four of six studies.
02Muscle strength was linked to better balance, especially quadriceps and ankle strength, while knee range of motion was not significant when strength was included.
03The two knee-sleeve studies disagreed, and custom-molded insoles showed no significant correlation with balance after 6 months.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only published articles were searched, and grey literature was not included, so publication bias is possible. The included studies reported multiple significant results, making it difficult to tell which factor was independently associated with balance. Balance was measured in different ways, including static balance, dynamic balance, single-leg standing balance, perturbation responses and postural control, so results are not directly comparable. Some factors, such as cognitive loading and custom-molded insoles, were supported by only one study. No studies were excluded on quality grounds, although quality scores varied.
Declared interests
The authors declared no personal conflicts of interest and reported no specific grant from public, commercial, or not-for-profit funding agencies.
The easy way to misread this
Do not treat weight loss, strengthening, knee sleeves or insoles as proven ways to improve balance in knee osteoarthritis. This review mainly reports associations, and the intervention studies on sleeves and insoles gave mixed or null balance results.