Balance dysfunction and falls in people with lower limb arthritis: factors contributing to risk and effectiveness of exercise interventions

Chronic musculoskeletal conditions in the lower extremities, particularly arthritis, and the chronic pain associated with them, are independent risk factors for falls, with approximately 50% of people with arthritis reporting one or more falls. Despite this, few studies have specifically addressed balance dysfunction, falls risk and falls incidence in people with arthritis. This review aimed to identify potential factors contributing to the increased risk of falls in people with lower limb osteoarthritis or rheumatoid arthritis and to summarise the evidence base for effective exercise interventions targeted to reduce their risk of falls. A systematic search of the literature was conducted in February 2010 and included the following databases: MEDLINE (Ovid), EMBASE, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine, Cochrane Library and PsycINFO. Only three studies that investigated exercise programmes for people with lower limb arthritis met all inclusion criteria, but none used falls as an outcome measure. To broaden the review, systematic reviews that assessed the effectiveness of exercise interventions for fall prevention in older people were also included. The presence of any form of lower limb arthritis and the associated consequences including pain, balance impairment, reduced muscle strength and reduced function are all associated with increased risk of falling. Due to the link between musculoskeletal pain and the increased risk of falls, further research needs to investigate which type of exercise programme will be effective in reducing the risk of falls in populations with arthritis in the lower limbs.

• Publication year

  2012

• Venue

  European Review of Aging and Physical Activity

• Publication date

  2012-04-01

• Fields of study

  Medicine

• Identifiers
  DOI 10.1007/s11556-011-0086-9
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar

• No claims are published for this paper.

• No concepts are published for this paper.

• Hospitalisations due to falls by older people, Australia 2005-06

  2013cited by this paper
• Physiological risk factors for falls in people with knee osteoarthritis before and early after knee replacement surgery

  2011cited by this paper
• A review of the clinical evidence for exercise in osteoarthritis of the hip and knee.

  2011cited by this paper
• The effect of aquatic exercise and education on lowering fall risk in older adults with hip osteoarthritis.

  2010cited by this paper
• Ageing and gait variability--a population-based study of older people.

  2010cited by this paper
• Quantifying the magnitude of risk for balance impairment on falls in community-dwelling older adults: a systematic review and meta-analysis.

  2010cited by this paper
• Exercise for Osteoarthritis of the Knee

  2010cited by this paper
• Health beliefs before and after participation on an exercised-based rehabilitation programme for chronic knee pain: Doing is believing

  2010cited by this paper
• Feasibility and outcomes of a home-based exercise program on improving balance and gait stability in women with lower-limb osteoarthritis or rheumatoid arthritis: a pilot study.

  2010cited by this paper
• A Randomized Study of the Effects of T'ai Chi on Muscle Strength, Bone Mineral Density, and Fear of Falling in Women with Osteoarthritis

  2010cited by this paper
• Exercise for osteoarthritis of the hip.

  2009cited by this paper
• The economic burden of osteoarthritis.

  2009cited by this paper
• Physical activity recommendations for older Australians

  2009cited by this paper
• Chronic musculoskeletal pain and the occurrence of falls in an older population.

  2009cited by this paper
• Interventions for preventing falls in older people living in the community.

  2009cited by this paper
• Physical activity programs for chronic arthritis

  2009cited by this paper
• Physical activity in women with arthritis: examining perceived barriers and self-regulatory efficacy to cope.

  2009cited by this paper
• Effective Exercise for the Prevention of Falls: A Systematic Review and Meta‐Analysis

  2008influential reference
• Major depression as a risk factor for chronic disease incidence: longitudinal analyses in a general population cohort.

  2008cited by this paper
• Exercise for osteoarthritis of the knee (2008)

  2008cited by this paper
• Factors associated with physical activity of patients with osteoarthritis of the lower limb.

  2008cited by this paper
• Participation restrictions among older adults with osteoarthritis: a mediated model of physical symptoms, activity limitations, and depression.

  2008cited by this paper
• Arthritis disability and heart disease disability.

  2008cited by this paper
• Efficacy of progressive resistance training on balance performance in older adults : a systematic review of randomized controlled trials.

  2008cited by this paper
• OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines.

  2008cited by this paper
• The reliability and predictive accuracy of the falls risk for older people in the community assessment (FROP-Com) tool.

  2008cited by this paper
• Epidemiology of balance and dizziness in a national population: findings from the English Longitudinal Study of Ageing.

  2008cited by this paper
• Strength training for treatment of osteoarthritis of the knee: a systematic review.

  2008cited by this paper
• The association of depression and anxiety with medical symptom burden in patients with chronic medical illness.

  2007cited by this paper
• Preventing Falls in Physically Active Community-Dwelling Older People: A Comparison of Two Intervention Techniques

  2007cited by this paper
• Physical activity recommendations and decreased risk of mortality.

  2007cited by this paper
• Aquatic exercise for the treatment of knee and hip osteoarthritis.

  2007cited by this paper
• Falls risk is associated with pain and dysfunction but not radiographic osteoarthritis in older adults: Tasmanian Older Adult Cohort study.

  2006cited by this paper
• The costs of fatal and non-fatal falls among older adults

  2006cited by this paper
• What Tools Help Make “Whole‐of‐Patient” Practices Happen?: A Tasmanian Falls Prevention Project

  2006cited by this paper
• Increasing postural sway in rural-community-dwelling elderly persons with knee osteoarthritis

  2006cited by this paper
• Active involvement and long-term goals influence long-term adherence to behavioural graded activity in patients with osteoarthritis: a qualitative study.

  2006cited by this paper
• Exercise self-efficacy, exercise benefits and barriers, and commitment to a plan for exercise among Korean women with osteoporosis and osteoarthritis.

  2006cited by this paper
• The Physical Performance Test as a predictor of frequent fallers: a prospective community-based cohort study

  2006cited by this paper
• Ottawa panel evidence-based clinical practice guidelines for therapeutic exercises and manual therapy in the management of osteoarthritis.

  2005cited by this paper
• Aerobic walking or strengthening exercise for osteoarthritis of the knee? A systematic review

  2005cited by this paper
• Exercise and well-being: a review of mental and physical health benefits associated with physical activity

  2005cited by this paper
• Prevalence, outcome and risk for falling in 155 ambulatory patients with rheumatic disease

  2005cited by this paper
• Body composition and muscle strength in women scheduled for a knee or hip replacement. A comparative study of two groups of osteoarthritic women

  2005cited by this paper
• Effects of physical activity on life expectancy with cardiovascular disease.

  2005cited by this paper
• Evidence-based recommendations for the role of exercise in the management of osteoarthritis of the hip or knee--the MOVE consensus.

  2005cited by this paper
• Association of Sensorimotor Function with Knee Joint Kinematics During Locomotion in Knee Osteoarthritis

  2004cited by this paper
• Epidemiology of osteoarthritis in Australia

  2004cited by this paper
• Muscle Weakness and Falls in Older Adults: A Systematic Review and Meta‐Analysis

  2004cited by this paper
• Barriers and motivations to exercise in older adults.

  2004cited by this paper
• Physiological risk factors for falls in older people with lower limb arthritis.

  2004cited by this paper
• Predisposing factors for occasional and multiple falls in older Australians who live at home.

  2004cited by this paper
• ACSM's exercise management for persons with chronic diseases and disabilities

  2003cited by this paper
• Motivators and Barriers to Exercise in an Older Community-Dwelling Population

  2003cited by this paper
• Association between falls in elderly women and chronic diseases and drug use: cross sectional study

  2003cited by this paper
• Musculoskeletal Pain and Risk for Falls in Older Disabled Women Living in the Community

  2002cited by this paper
• The epidemiology of falls and syncope.

  2002cited by this paper
• A risk model for the prediction of recurrent falls in community-dwelling elderly: a prospective cohort study.

  2002cited by this paper
• Effect of pain reduction on postural sway, proprioception, and quadriceps strength in subjects with knee osteoarthritis

  2002cited by this paper
• Hip muscle strength and muscle cross sectional area in men with and without hip osteoarthritis.

  2002cited by this paper
• Therapeutic exercise for people with osteoarthritis of the hip or knee. A systematic review.

  2002cited by this paper
• Balance impairments in individuals with symptomatic knee osteoarthritis: a comparison with matched controls using clinical tests.

  2002cited by this paper
• Managing arthritis with exercise.

  2001cited by this paper
• Visual Risk Factors for Falls in Older People

  2001cited by this paper
• Static postural sway, proprioception, and maximal voluntary quadriceps contraction in patients with knee osteoarthritis and normal control subjects

  2001cited by this paper
• Postural sway characteristics in women with lower extremity arthritis before and after an aquatic exercise intervention.

  2000cited by this paper
• The role of pain anxiety, coping, and pain self-efficacy in rheumatoid arthritis patient functioning.

  2000cited by this paper
• Factors that modify the association between knee pain and mobility limitation in older women: the Women's Health and Aging Study

  2000cited by this paper
• Skeletal muscle mass and distribution in 468 men and women aged 18-88 yr.

  2000cited by this paper
• Lower-extremity muscle force and balance performance in adults aged 65 years and older.

  1999cited by this paper
• Drugs and Falls in Older People: A Systematic Review and Meta‐analysis: I. Psychotropic Drugs

  1999cited by this paper
• Falls among healthy, community‐dwelling, older women: a prospective study of frequency, circumstances, consequences and prediction accuracy

  1999cited by this paper
• Falls in older Mexican-American women.

  1999cited by this paper
• Epidemiology of sarcopenia among the elderly in New Mexico.

  1998cited by this paper
• ACSM’s Exercise Management for Persons with Chronic Diseases and Disabilities

  1998cited by this paper
• The occurrence of falls among patients with a new episode of hip pain

  1998cited by this paper
• Facilitators, barriers, and strategies for exercise in European American women in the community.

  1998cited by this paper
• Correlates of fear of falling and activity limitation among persons with rheumatoid arthritis.

  1997cited by this paper
• Incidence, risk factors and consequences of falls among elderly subjects living in the community A criteria-based analysis

  1997cited by this paper
• Sensorimotor changes and functional performance in patients with knee osteoarthritis

  1997cited by this paper
• Quadriceps Weakness and Osteoarthritis of the Knee

  1997cited by this paper
• Reduced muscle function in patients with osteoarthritis.

  1997cited by this paper
• A survey of exercise beliefs and exercise habits among people with arthritis.

  1996cited by this paper
• The effects of exercise on falls in elderly patients. A preplanned meta-analysis of the FICSIT Trials. Frailty and Injuries: Cooperative Studies of Intervention Techniques.

  1995cited by this paper
• Strength is a major factor in balance, gait, and the occurrence of falls.

  1995cited by this paper
• Shared risk factors for falls, incontinence, and functional dependence. Unifying the approach to geriatric syndromes.

  1995cited by this paper
• The Effect of a 12‐Month Exercise Trial on Balance, Strength, and Falls in Older Women: A Randomized Controlled Trial

  1995cited by this paper
• Physiological Factors Associated with Falls in Older Community‐Dwelling Women

  1994cited by this paper
• Falls in older people

  1994cited by this paper
• Effects of ageing on the motor unit: a brief review.

  1993cited by this paper
• Incidence of and risk factors for falls and injurious falls among the community-dwelling elderly.

  1993cited by this paper
• Fear of Falling among the Community-Dwelling Elderly

  1993cited by this paper
• Physiological factors associated with injurious falls in older people living in the community.

  1992cited by this paper
• Muscle strength, endurance, and aerobic capacity in rheumatoid arthritis: a comparative study with healthy subjects.

  1992cited by this paper
• Fear of falling and postural performance in the elderly.

  1991cited by this paper
• Physiological Factors Associated with Falls in an Elderly Population

  1991cited by this paper
• Standing balance in rheumatoid arthritis. A comparative study with healthy subjects.

  1989cited by this paper
• Predictors of falls among elderly people. Results of two population-based studies.

  1989cited by this paper
• Risk factors for falls in a community-based prospective study of people 70 years and older.

  1989cited by this paper
• Falls by elderly people at home: prevalence and associated factors.

  1988cited by this paper

• Independent and joint associations of vision and hearing impairments with arthritis: Findings from a population‐based study

  2025cites this paper
• A 24-week physical activity program implemented in long-term care facilities during COVID-19: Effects on functional fitness in older adults over 70

  2025cites this paper
• Healthy aging reduces dynamic balance control as measured by the simplified Star Excursion Balance Test.

  2023cites this paper
• Diuretics, SGLT2 inhibitors and falls in older heart failure patients: to prescribe or to deprescribe? A clinical review

  2023cites this paper
• Fall risk in patient with dysplastic hip osteoarthritis

  2023cites this paper
• Severe low back or lower limb pain is associated with recurrent falls among older Australians

  2022cites this paper
• The Prevalence of Fall and Related Factors in Iranian Elderly: A Systematic Review

  2020cites this paper
• Risk Factors for Falls in Adults with Knee Osteoarthritis: A Systematic Review

  2019cites this paper
• FALL RISK AND RELATED FACTORS IN KNEE OSTEOARTHRITIS

  2018cites this paper
• Safety and feasibility of high speed resistance training with and without balance exercises for knee osteoarthritis: A pilot randomised controlled trial.

  2018cites this paper
• The Effects of Exercise Intervention for Fall Prevention in Persons with Arthritis: A Meta Analysis

  2017cites this paper
• The effect of vitamin D status on pain, lower limb strength and knee function during balance recovery in people with knee osteoarthritis: an exploratory study

  2017cites this paper
• Biomechanical balance response during induced falls under dual task conditions in people with knee osteoarthritis.

  2016cites this paper
• Falls in people prior to undergoing total hip or total knee replacement surgery: Frequency and associated factors

  2016cites this paper
• Stepping strategy used to recover balance during an induced fall is associated with impaired function and strength in people with knee osteoarthritis

  2016cites this paper
• [The influence of physical function on the risk of falls among adults with rheumatoid arthritis].

  2014cites this paper
• Balance and falls risk in women with lower limb osteoarthritis or rheumatoid arthritis

  2013cites this paper
• Advancing physical activity in older Australians: Missed opportunities?

  2012cites this paper
• Perception of Falls and Confidence in Self-Management of Falls among Older Adults

  year unknowncites this paper
• The Lower Extremity Functional Scale

  year unknowncites this paper