Biomechanical balance response during induced falls under dual task conditions in people with knee osteoarthritis

Publication date: Available online 6 May 2016
Source:Gait & Posture
Author(s): Pazit Levinger, Hanatsu Nagano, Calum Downie, Alan Hayes, Kerrie M Sanders, Flavia Cicuttini, Rezaul Begg
ObjectivePeople with knee osteoarthritis (OA) are at twice the risk of falling compared to older people without knee OA, however the mechanism for this is poorly understood. This study investigated the biomechanical response of the trunk and lower limb joints during a forward induced fall under different task conditions in people with and without knee OA.MethodTwenty four participants with OA (68.6±6.2 years) and fifteen asymptomatic controls (72.4±4.8 years) participated in the study. Forward fall was induced by releasing participants from a static forward leaning position. Participants were required to recover balance during three conditions: normal, physical (obstacle clearance) and cognitive dual tasks (counting backwards). Spatiotemporal parameters, lower limb joint kinematics and kinetics of the recovery limb were compared between the two groups and across the three task conditions.ResultsThe OA group demonstrated slower spatio-temporal characteristics and reduced hip and knee flexion angles, joint moments/powers and reduced muscle negative work at the knee and ankle (p<0.05). Cognitive dual task resulted in reduced centre of mass velocity and step length (p=0.03) compared to the physical dual task condition. Reduced knee (p=0.02) and hip joint powers (p=0.03) were demonstrated in the OA group in the physical task condition.ConclusionWhen simulating a forward fall, participants with OA demonstrated difficulty in absorbing and slowing down the forward momentum of the body during a recovery step. Moreover, poor dynamic postural control was demonstrated as task complexity increased.



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