Correlation of Fears and Beliefs About Knee Osteoarthritis with Balance in Patients with Osteoarthritis of Knee

Background:Knee osteoarthritis (OA) damages the proprioceptors within the joint cavity which in turn may lead to impairment of balance, an integral part of mobility.Fears and beliefs about knee osteoarthritis in patients with knee osteoarthritis are found to have an adverse impact on their function. Objectives:The study aimed to evaluate the correlation between fearsand beliefs about knee osteoarthritis and balance in patientswith Knee OA. Material andMethods:In an observational analytical study males and females with OA knee were included. Fears and beliefs wereassesse d usingthe Knee Osteoarthritis Fears and Beliefs Questionnaire (KOFBeQ), balancewas tested using the Functional Reach Test (FRT) and pain was assessed by Visual Analogue Scale (VAS).Result:Forty-six patients were evaluated. Mean pain scorewas 4±1.5, FRT score 8.7±2.4inches, KOFBeq score33 ±13.8. Correlation was found using Spearman coefficient, r=0.178, p=0.23(balance and KOFBeq), r=-0.264, p=0.7 (pain and balance), r=-0.3, p=0.018(pain and KOFBeq) was seen.Conclusion:Fears and beliefs about knee osteoarthritis were present with impaired functional balance. Weaknegative correlationwas found between pain and balance and pain and fears and beliefs and no correlation were found between balance and fearsand beliefs.

Advance in Application of Functional Reach Test (review) / 中国康复理论与实践

The evaluation of balance includes clinical observation, scales and instrumental measures. Functional Reach Test is simple and can be carried out in both standing and sitting, but the error of reading the measuring ruler is large, which results in new moving rulers and inertial sensors. The factors influencing the results of Functional Reach Test are moving strategy, age, moving efficiency, goal orientation, single or double arms, human characteristics, number of experiments and others. In the future, combination of electromyogram and inertia sensor can be used to discuss the variety of muscles and the changes of muscle strength, and more influence factors for the test are needed to research.

Effect of Multicomponent Exercise Program on Selected Gait and Balance Parameters in Young Obese Females.

Obesity is a major global health problem. It is now commonly seen in young population due to their lifestyle and unhealthy eating habits. Obesity is now more common in younger females. Due to hormonal changes, body may not adapt, which may lead to life threatening and irreversible conditions. Obesity affects many physical factors including gait and balance. We wanted to study the correlation between obesity and gait-balance parameters, the effect of multi component exercise program on selected gait and balance parameters in young obese females. We also wanted to study its effect on dynamic balance, and compare it with conventional exercise program.METHODSIn this comparative study two groups were created with 20 participants with obesity grade 1 BMI in each. Group 2 underwent 26 weeks of multi component exercise. Group 1 underwent conventional exercises. Data was assessed and analysed. Outcome measures were body mass index, base of support, stride length, step length, cadence, and functional reach test.RESULTSBody mass index for group 1 after their conventional exercise decreased in 47% while in group 2 with multi component exercise protocol BMI reduced in 53% population. Similarly base of support for group 1 was 42% and group 2 was 58%; stride length in group 1 was 42% and group 2 was 58%; step length for group 1 was 42% and group 2 was 58%; cadence for group 1 was 42% and group 2 was 58%; functional reach test was 42% and 58% for group 1 and group 2 respectively.CONCLUSIONSA significant improvement was found in selected gait and balance parameters in young obese women with the help of multi component exercise program.

Efficacy Of Perturbation Training In Improving Balance And Function In The Management Of Knee Osteoarthritis

Background: Subjects who are suffering from osteoarthritis of the knee will have problems including progressive loss of function, depending on walking, climbing stairs, and it may affect lower extremity functions. Balance is a major component required for the activities of daily living and functions. The objective of the study was to compare the effectiveness of perturbation training and conventional physiotherapy in improving balance and function in the rehabilitation of knee osteoarthritis. Method: Study design was an experimental study. Thirty subjects (16 males and 14 females) suffering from knee osteoarthritis were randomized into a control group and experimental group. Fifteen subjects in the control group were treated with traditional methods like ultrasound, stretching and strengthening, and fifteen subjects in the experimental group were given perturbation training along with the conventional method. Outcome measures used were Timed get up and go test score (TUG) and Functional reach test score (FRT) scales, pre-assessed on Day 1. Each group received 14 sessions of treatment, after which post-assessment of outcome measures was done. Results: Timed get up and go test score was reduced in both groups after training, which was statistically significant (p<.05). The functional reach test score was increased after training in both groups, which was statistically significant (p<.05). However, comparing between groups, the experimental group showed more reduction in TUG score and improvement in the FRT score, which was statistically significant (p<.05). Conclusion: Perturbation training given with conventional treatment was found to have a significantly better effect in improving the function of the lower extremity in OA knee subjects. However, a well-designed trial, including a larger sample size with repeated measurements, is needed to find out the effectiveness of training with perturbation in the management of knee osteoarthritis and generalize it in a larger population.

Rethinking the neurological examination I: static balance assessment / Repensando o exame neurológico I: avaliação do equilíbrio estático

The authors advocate a modernization of the neurologic exam with regard to the evaluation of static equilibrium through the application of some easily performed and interpreted bedside maneuvers like the Clinical Test of Sensory Integration and Balance - modified and the Functional Reach Test. The authors also believe that these and other assessments, such as that of the risk of falling for elderly patients, should be incorporated into the routine neurological examination.

Os autores advogam a modernização do exame neurológico no que diz respeito à pesquisa do equilíbrio estático, por meio da aplicação de algumas manobras de beira-de-leito fáceis de serem executadas e interpretadas, tais como o Teste Clínico de Integração Sensorial e Equilíbrio-modificado e o Teste do Alcance Funcional. Os autores também acreditam que estes e outros testes visando avaliação de risco de queda em pacientes idosos devem fazer parte do exame neurológico de rotina.

Effects of obesity on balance and gait alterations in young adults.

The effects of obesity on the balance and gait parameters like step width and foot angle (degree of toe out) in young adults were studied. 60 subjects of both the genders were taken. 30 were taken as a control group (non-obese, BMI < 25) and 30 were taken as experimental group (obese, BMI 30 >). Functional Reach Test (FRT) was used for Balance Testing and the Footprint method was used for Gait parameters measurements. The value of functional reach test in females was 11.90±0.12 inches in control group and 7.01±1.80 inches in experimental group (t=5.31, P<0.001) and in males, it was 16.45±0.72 inches in control and 11.66±0.53 inches in experimental group (t=6.47, P<0.001). The degree of toe out in females was 6.66±0.08 degrees for control and 8.13±0.21 degrees for experimental group (t=4.08, P<0.01) and in males, it was 6.59±0.04 for control and 9.79±0.51 for experimental group (t=6.53, P<0.001). The step width was found to be 4.41±0.15 inches (control group) and 6.27±0.35 inches (experimental) in males (t=4.53, P<0.01) and it was 3.95±0.03 inches (control) and 3.42±1.05 inches (experimental) in females (t=0.77, P>0.05). We concluded that obesity has a negative impact on balance of an individual. The degree of toe out was more in obese group as compared to normal BMI group in both genders. The Step Width measurement was more in males of obese group than that in males of normal BMI group but it showed statistically insignificant when compared in females of both groups.

Application of Functional Reach Test in Assessment of Fall Risk in Stroke Patients with Hemiplegia / 中国康复理论与实践

@# ObjectiveTo examine the application of functional reach test(FRT) in the assessment of fall risk in stroke patients with hemiplegia.MethodsThis study used a randomized repeated measures trial design. 51 post-stroke patients with hemiplegia were recruited and were assigned into three groups, fallen group, falling group and no-fall group, according to the result of the survey on the patients' history of fall. FRT was performed for the three groups respectively to obtain confidence interval that predict fall risk more effectively according to the result of FRT. Fall risk by confidence lower limit was predicted.ResultsThe reaching distance anteriorly and posteriorly in FRT was highly correlated of the number of fall(r=-0.788，P<0.01). When the reaching distance was lower than 42.15 cm, the fall risk of the examinee was highest.ConclusionFRT can be applied to predict the fall risk of the examinee, and can also be used in the assessment of fall risk in stroke patients with hemiplegia.

Evaluation of Standing Balance in Hemiplegic Patients Using the Functional Reach Test

OBJECTIVE: To examine the validity of the fuctional reach test (FRT) for evaluation of standing balance in hemiplegic patients. METHOD: Twenty three hemiplegic patients who were capable of standing without assistive devices were assessed on the FRT only with intact upper limb, the one-legged stance, the timed up and go test (TUG), the 10 meter walking time (10 mWT), the 'Hauser' ambulation index (AI), and the standing balance of Bohannon. RESULTS: The forward reach of FRT demonstrated significant correlation with the TUG and the 10 mWT (p<0.01), but no significant relationship with the one-legged stance, standing balance of Bohannon and AI. CONCLUSION: The forward reach of FRT may be simple and useful tool for assessing the clinical balance function and reflecting gait ability and fall-down risk in hemiplegic patients.

The Effects of Ankle Plantar Flexors Stretching Exercise on Functional Reach in Elderly Men

OBJECTIVE: To determine whether ankle plantar flexors stretching exercise affects functional reach in elderly men. METHOD: Twenty elderly men with an average age of 78.2 years were selected for this study. A active range of motion of ankle dorsiflexion and a functional reach (FR) distance were measured before and after ankle stretching exercise. The ankle dorsiflexion was measured by goniometer in knee extended position. The FR distance was measured in standing position. Ankle plantar flexors stretching exercises were carried out by physical therapist 4 times per week for 4 weeks. At 4 weeks after the stretching exercise, we retested the active range of motion of ankle dorsiflexion and the FR distance using the same method. RESULTS: At 4 weeks after the stretching exercise, the active range of motion of right ankle dorsiflexion was increased from 2.81 +/- 3.26degrees to 5.98 +/- 4.34degrees, and the left ankle dorsiflexion was increased from 3.15 +/- 3.77degrees to 6.35 +/- 2.45degrees. The FR distance was increased form 12.22 +/- 7.54 cm to 19.69 +/- 8.59 cm after the stretching exercise. CONCLUSION: The FR distance was significantly increased after the ankle plantar flexors stretching exercise (p<0.01). This results suggest that the ankle plantar flexors stretching excercise may be capable of increasing the FR distance in elderly.