Graduate School of Medicine, Musculoskeletal Reconstructive Surgery, Nara Medical University, Nara, Japan.
Department of Rehabilitation Medicine, Nara Medical University, Nara, Japan.
PLoS One. 2023 Mar 13;18(3):e0282944. doi: 10.1371/journal.pone.0282944. eCollection 2023.
Knee osteoarthritis (KOA), one of the most common musculoskeletal diseases in older adults, is associated with a high incidence of falls. Similarly, toe grip strength (TGS) is associated with a history of falls in older adults; however, the relationship between TGS and falls in older adults with KOA who are at risk of falling is not known. Therefore, this study aimed to determine if TGS is associated with a history of falls in older adults with KOA.
The study participants, older adults with KOA scheduled to undergo unilateral total knee arthroplasty (TKA), were divided into two groups: non-fall (n = 256) and fall groups (n = 74). Descriptive data, fall-related assessments, modified Fall Efficacy Scale (mFES), radiographic data, pain, and physical function including TGS were evaluated. The assessment was conducted on the day before performing TKA. Mann-Whitney and chi-squared tests were performed to compare the two groups. Multiple logistic regression analysis was performed to determine the association of each outcome with the presence or absence of falls.
Mann-Whitney U test revealed that the fall group had statistically significantly lower height, TGS on the affected and unaffected sides, and mFES. Multiple logistic regression analysis revealed that the incidence of fall history is associated with TGS on the affected side; the weaker the affected TGS of the KOA, the more likely the individual is to fall.
Our results indicate that TGS on the affected side is related to a history of falls in older adults with KOA. The significance of evaluating TGS among patients with KOA in routine clinical practice was demonstrated.
膝骨关节炎(KOA)是老年人中最常见的肌肉骨骼疾病之一,与高发跌倒事件相关。同样,脚趾握力(TGS)与老年人的跌倒史有关;然而,对于有跌倒风险的 KOA 老年患者,TGS 与跌倒之间的关系尚不清楚。因此,本研究旨在确定 TGS 是否与 KOA 老年患者的跌倒史有关。
研究参与者为计划接受单侧全膝关节置换术(TKA)的 KOA 老年患者,分为非跌倒组(n=256)和跌倒组(n=74)。评估内容包括描述性数据、与跌倒相关的评估、改良跌倒效能量表(mFES)、影像学数据、疼痛以及包括 TGS 在内的身体功能。评估于行 TKA 前一天进行。采用 Mann-Whitney 和卡方检验比较两组。采用多变量逻辑回归分析确定每个结果与跌倒发生或不发生的关系。
Mann-Whitney U 检验显示,跌倒组在身高、患侧和健侧 TGS 以及 mFES 方面均显著较低。多变量逻辑回归分析显示,跌倒史的发生与患侧 TGS 有关;KOA 患侧 TGS 越弱,个体跌倒的可能性越大。
我们的结果表明,KOA 老年患者患侧 TGS 与跌倒史有关。评估 KOA 患者的 TGS 在常规临床实践中的重要性得到了证明。