Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand.
PM R. 2019 Jul;11(7):745-757. doi: 10.1002/pmrj.12066. Epub 2019 Mar 28.
OBJECTIVE: To examine the evidence of risk factors for falls in adults with knee osteoarthritis (OA). TYPE: Systematic Review. METHODOLOGY: A systematic literature search was performed in 9 electronic databases from inception to July 2016. Two reviewers screened articles using set inclusion and exclusion criteria. Observational study designs that included participants with knee OA and history of falls were considered. Results reported as odds ratios, relative risks, prevalence ratios, or hazard ratios were extracted to identify the potential risk factors for falls. Included articles were assessed for methodological quality and level of evidence. SYNTHESIS: The electronic data search yielded 4382 studies related to falls and knee OA. A total of 11 studies were included in the review. The risk factors for falls in individuals with knee OA included impaired balance, muscle weakness, presence of comorbidities, and increasing number of symptomatic joints. The presence of knee pain was also identified as a risk factor for falls; however, the strength of evidence was rated as "conflicting" because of the inconsistency of the findings. Limited evidence was found for knee instability, impaired proprioception, and use of walking aids. CONCLUSION: This review provides evidence of risk factors for falls in individuals with knee OA. Despite the limited to moderate evidence, identification of these risk factors may be valuable for both clinicians and fall prevention program developers. Further studies are warranted to determine which of these risk factors for falls are modifiable in a knee OA population. LEVEL OF EVIDENCE: I.
目的:探讨膝关节骨关节炎(OA)成年人跌倒的危险因素的证据。类型:系统评价。
方法:从 2016 年 7 月开始,在 9 个电子数据库中进行了系统文献检索。两名审查员使用设定的纳入和排除标准筛选文章。纳入了包括膝关节 OA 病史和跌倒史的参与者的观察性研究设计。提取报告为比值比、相对风险、患病率比或风险比的结果,以确定跌倒的潜在危险因素。纳入的文章进行了方法学质量和证据水平评估。
综合:电子数据检索与跌倒和膝关节 OA 相关的研究共 4382 项。共有 11 项研究纳入综述。膝关节 OA 患者跌倒的危险因素包括平衡障碍、肌肉无力、合并症存在和症状性关节数量增加。膝关节疼痛的存在也被确定为跌倒的危险因素;然而,由于研究结果的不一致,证据强度被评为“矛盾”。有限的证据表明膝关节不稳定、本体感觉受损和使用助行器。
结论:本综述提供了膝关节 OA 患者跌倒危险因素的证据。尽管证据有限到中等,但确定这些危险因素对于临床医生和跌倒预防计划的开发者可能是有价值的。需要进一步的研究来确定这些跌倒危险因素中哪些在膝关节 OA 人群中是可以改变的。
证据水平:I。
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