Association of balance with kinesiophobia and physical function in knee osteoarthritis

Balance appears to be affected by several neuromuscular variables, and there is conflicting evidence related balance and kinesiophobia in patients with lower extremity osteoarthritis (OA). The purpose of this study was to investigate the potential association between static and dynamic balance abilities, kinesiophobia, and lower extremity functions in knee OA patients.

A total of 43 patients with knee OA were included in this cross-sectional study. The visual analog scale (VAS) was used to evaluate the degree of pain. The patients were assessed using the Berg Balance Scale (BBS), the Tampa Scale for Kinesiophobia (TSK), and the Western Ontario McMaster Universities Osteoarthritis (WOMAC). The thickness of the femoral cartilage, quadriceps muscle, and rectus abdominis muscle was measured by ultrasound. Posturography was used for analyzing both static and dynamic postural control.

Patients were divided into high and low risk groups based on BBS scores. The group with a high fall risk had greater pain levels at rest (p = 0.002) and activity (p = 0.007), higher kinesiophobia levels (p < 0.001), higher WOMAC total (p = 0.001), pain (p = 0.002), stiffness (p = 0.006), and physical function scores(p = 0.001), as well as worse balance assessments (p < 0.001). TSK and WOMAC total score were independent predictors of BBS for clinical parameters (r² = 0.626), and LOS anterior was an independent predictor of BBS for balance parameters (r² = 0.091), according to linear regression analysis.

The existence of kinesiophobia and balance difficulties in these patients highlights the importance of rehabilitation interventions to decrease participation restrictions and disability. Therefore, as OA pain and associated dysfunctions appear to be multidimensional in nature, a more comprehensive biopsychosocial approach to knee OA treatment is needed.