According to the Centers for Disease Control and Prevention (CDC), one in three older people fall each year. Knee instability is a common cause of falls in the elderly, leading to serious health problems. A recent study published in Arthritis Care & Research has found that exercises and treatments targeting knee buckling – the condition in which the knees give out – could prevent falls in older adults. The findings suggest that such treatments should form an important component of geriatric care.
The knees provide stability and strength to support the weight of the body. The bones, cartilage, muscles, ligaments, and tendons of the knees are susceptible to disease and injury, more so as you grow older. Osteoarthritis, which is associated with aging and usually begins in people age 50 or older, weakens the knees and increases the risk of falls.
The study, conducted by researchers at the University of California, San Francisco, has shown for the first time that knee pain, knee instability and knee buckling cause problems such as falls, injury from falls, and poor balance confidence in older adults. The team studied 1842 participants in the Multicenter Osteoarthritis Study (MOST) who were an average of 67 years old at the start of the study and who had, or were at high risk for, knee osteoarthritis. The researchers found that:
- At the end of 5 years, 16.8 percent reported knee buckling
- At the end of 7 years, 14.1 percent had recurrent falls
- In year 5, those whose knees gave out had a 1.6- to 2.5-times higher risk of recurrent falls, fear of falling, and poor balance confidence at year 7
- Those who fell when a knee buckled at the start of the study were more than four times as likely to have experienced repeated falls in the next two years. They were also twice as likely to be seriously hurt in a fall, and had a 3-times higher likelihood 2 years later of recurrent falls, significant fall injuries, and fall injuries that limited activity. They were also 4 times more likely to have balance issues.
The experts concluded that older adults with symptoms of knee instability may indicate an increased risk of falling and of experiencing the various physical problems and diminished quality of life. They recommend that clinicians treating elderly patients with knee arthritis should focus on making exercises targeting knee buckling and instability a significant component of care.
Slip and fall prevention programs for older adults are available in professional health care centers in New York. A multispecialty team comprising geriatric care specialists, pain management physicians, and orthopedists will first assess the patient’s risk of falling, and then develop personalized treatment plans to modify these risk factors and improve stability. The conditioning part of the program would include special exercises to improve ankle and leg strength, dynamic balance training to help maintain physical balance even under challenging conditions, and gait training to manage walking speed and step length. As pain is the predominant symptom of knee osteoarthritis, such centers also offer structured pain management solutions for the elderly.