Sensory integration strategies for static balance control in older adults with knee osteoarthritis

ObjectiveTo preliminarily investigate sensory integration strategies of proprioception, vision and vestibular sensation in static balance control in patients with knee osteoarthritis.DesignRepeated-measures design.SettingA university-based rehabilitation assessment laboratory.Participants69 patients with knee osteoarthritis (19 men, 50 women).InterventionsNot applicable.Main outcome measuresStatic balance metrics (centre of pressure displacement in the mediolateral and anteroposterior directions, sway velocity) were recorded using a Pro-Kin platform under four conditions: firm support with eyes open (T1), firm support with eyes closed (T2), foam support with eyes open (T3) and foam support with eyes closed (T4). Sensory contributions were estimated using sway velocity-based ratios.ResultsCentre of pressure displacement in the mediolateral and anteroposterior directions differed between T1-T4, T1-T3 and T2-T3 (P < 0.05), and centre of pressure displacement in the anteroposterior direction also differed between T2-T4. Sway velocity increased when proprioception or vision was disrupted. With full sensory input, vestibular sensation, proprioception and vision contributions were 62.07%, 21.87% and 15.49%. Removing vision raised proprioception to 32.58% and vestibular sensation to 67.42%. Removing proprioception elevated vision to 28.75% and vestibular sensation to 71.25%.ConclusionsIn individuals with knee osteoarthritis, balance control depends mainly on vestibular sensation, then proprioception and least on vision. Without vision, proprioception contributes more in the sagittal plane. The central nervous system can reorganise and optimise postural control. Therefore, rehabilitation should include vestibular training, sagittal-plane proprioceptive training without vision and multisensory coordination.