Knee Extensor Muscle Strength Is More Important Than Postural Balance for Stair-Climbing Ability in Elderly Patients with Severe Knee Osteoarthritis

Abstract

Knee osteoarthritis is a chronic joint disease which damages articular cartilage. In its severe stages, it results in impairments in balance and muscle strength loss, which affect daily life activities such as walking or climbing stairs. This study sought to investigate associated factors with stair-climbing ability in this population, with special interest in measuring the relevance of postural balance for this task. Forty-four patients scheduled to undergo unilateral total knee arthroplasty were assessed. Timed up and go test, stair ascent–descent test, three different isometric strength tests (knee flexion, knee extension and hip abduction), active knee extension and flexion range of movement and static postural balance assessment were evaluated. Spearman’s correlation coefficients and multiple linear regression analysis determined the strength of association between the different variables and stair-climbing time. No significant association between the stair-climbing time and static balance was found. Significant associations were found between stair-climbing time and timed up and go (r = 0.71; p < 0.0001) and maximal knee extensor strength (r = –0.52; p = 0.0003). One-year increase in age was associated with 0.15 s (95% CI 0.00 to 0.30) slower stair-climbing time. In conclusion, muscle strength is more important than postural balance for stair-climbing ability in this population.