Foley S J, Lord S R, Srikanth V, Cooley H, Jones G
Menzies Research Institute, University of Tasmania, Australia.
Osteoarthritis Cartilage. 2006 Jun;14(6):533-9. doi: 10.1016/j.joca.2005.12.007. Epub 2006 Feb 3.
To describe the association between knee and hip radiographic osteoarthritis (ROA), a measure of knee pain, stiffness and functional ability and objectively measured physiological falls risk predictors.
Cross-sectional, population-based study of 850 randomly selected men and women aged 50-80 years (mean 62.5, SD 7.4). Falls risk (Z score) was determined objectively with the short form Physiological Profile Assessment (PPA). Two observers assessed knee and hip ROA using the Altman atlas. Pain, stiffness and functional ability were assessed using the Western Ontario McMasters Osteoarthritis index (WOMAC).
Overall, the study population was at a mild risk of falling. In multivariable analysis, the WOMAC function and pain score were significantly associated with reaction time, balance, proprioception, knee extension strength, and edge contrast sensitivity. Stiffness was associated with knee extension strength and edge contrast sensitivity. Males had a dose response association between the global WOMAC score and falls risk (r=0.17, P<0.001). Those who reported a global WOMAC score of 50 and above had a higher risk of falling compared to those with a score below 50 (Z score: 0.53 vs 0.14, P<0.001). Hip joint space narrowing (JSN) was significantly associated with knee extension strength (r=-0.10, P=0.003), however, no other significant associations were observed between ROA and falls risk predictors.
Self-reported functional ability and pain, and to a lesser extent, stiffness (but not knee and hip ROA), have a modest but independent association with physiological predictors of falls risk.
描述膝关节和髋关节的影像学骨关节炎（ROA）、膝关节疼痛、僵硬及功能能力的一种测量指标与客观测量的生理跌倒风险预测指标之间的关联。
对850名年龄在50 - 80岁（平均62.5岁，标准差7.4）的随机选取的男性和女性进行基于人群的横断面研究。使用简化版生理特征评估（PPA）客观确定跌倒风险（Z评分）。两名观察者使用奥特曼图谱评估膝关节和髋关节的ROA。使用西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评估疼痛、僵硬和功能能力。
总体而言，研究人群处于轻度跌倒风险。在多变量分析中，WOMAC功能和疼痛评分与反应时间、平衡、本体感觉、膝关节伸展力量和边缘对比敏感度显著相关。僵硬与膝关节伸展力量和边缘对比敏感度相关。男性的WOMAC总体评分与跌倒风险之间存在剂量反应关联（r = 0.17，P < 0.001）。报告WOMAC总体评分在50及以上的人群与评分低于50的人群相比，跌倒风险更高（Z评分：0.53对0.14，P < 0.001）。髋关节间隙变窄（JSN）与膝关节伸展力量显著相关（r = -0.10，P = 0.003），然而，未观察到ROA与跌倒风险预测指标之间的其他显著关联。
自我报告的功能能力和疼痛，以及在较小程度上的僵硬（而非膝关节和髋关节的ROA），与跌倒风险的生理预测指标存在适度但独立的关联。
