Falls are a significant issue for patients with knee osteoarthritis, as they can lead to hospitalization or even more severe consequences. Therefore, it is crucial to assess fall risk early in rehabilitation clinics. Sarcopenia, which is the reduction of muscle mass, increases the risk of falls. This study involved 250 adults with knee osteoarthritis, using a technology called POCUS to assess muscle mass, combined with other tests to track fall incidents over three months. The study is expected to find correlations between falls and factors like muscle mass and grip strength. This information can help doctors better predict which patients are at risk of falling and take preventive measures early. Future research will explore the effectiveness of different prevention strategies.
Background Falls represent a significant health issue for patients with knee osteoarthritis, potentially leading to hospitalization, disability, or even death. Early screening for fall risk in rehabilitation clinics is crucial; however, challenges arise due to time constraints and individual differences among patients. Sarcopenia, characterized by a reduction in muscle mass, is closely associated with an increased risk of falls, and point-of-care ultrasound (POCUS) offers a non-invasive and effective tool for assessing muscle mass. Methods This prospective study involved 250 adults with knee osteoarthritis attending the orthopedic physical therapy outpatient department at National Taiwan University Hospital. POCUS technology was utilized to evaluate muscle mass, complemented by grip strength tests, lower limb strength assessments, self-reported fall risk questionnaires, sarcopenia assessments, get-up-and-go tests, thirty-second sit-to-stand tests, general nutrition screening for malnutrition, and bioimpedance analysis. A three-month follow-up study was conducted to monitor fall incidents. Expected Results During the three-month follow-up, it is anticipated that a certain proportion of participants will experience fall incidents. Significant correlations are expected to be identified between fall incidents and various measurements, including muscle mass assessed by POCUS, grip strength, lower limb strength, self-reported fall risk scores, sarcopenia assessments, get-up-and-go tests, thirty-second sit-to-stand tests, the geriatric nutritional risk index, and bioimpedance analysis. Differences between the fall group and the non-fall group on these variables will also be statistically significant, indicating that the combination of POCUS technology and other clinical assessment indicators enhances the predictive ability regarding fall risk in patients with knee osteoarthritis. Future Clinical Applications The integration of POCUS technology with other clinical assessment indicators may be applied in rehabilitation outpatient settings to screen for fall risk in adults with knee osteoarthritis, facilitating early intervention and prevention. Future research will investigate the effectiveness of various intervention strategies.
Study Type
OBSERVATIONAL
Enrollment
250
NTUH
Taipei, Taiwan
Fall Incident Tracking
Participants will be monitored for fall incidents over a three-month period, and the accuracy of the model predictions will be analyzed.
Time frame: Three-month period
Grip strength testing
Measures the maximum strength of hand and forearm muscles using a hand dynamometer. It reflects overall muscle function and the ability to perform daily tasks. Results are reported in kilograms or pounds.
Time frame: Baseline grip strength
POCUS Assessment
Point-of-care ultrasound is used to measure participants' muscle mass
Time frame: Baseline POCUS Assessment
Sarcopenia Risk Assessment Questionnaire (SARC-F)
An assessment tool designed to determine the risk of sarcopenia in individuals. Scale: The SARC-F consists of five questions scored from 0 to 10, with higher scores indicating a greater risk of sarcopenia.
Time frame: Baseline Sarcopenia Risk Assessment Questionnaire (SARC-F)
Bioelectrical Impedance Analysis (BIA) Measurement
Conduct bioelectrical impedance measurements to assess body composition, including fat mass and lean body mass. Unit of Measure: Results are typically presented in kilograms and percentage for fat mass and lean body mass.
Time frame: Baseline BIA measurement
Knee extension strength testing
Assesses the strength of the quadriceps by measuring the force exerted during knee extension against resistance, helping evaluate functional mobility. Results can be quantified as force or estimated one-repetition maximum.
Time frame: Baseline knee extension strength testing
Timed Up and Go (TUG) Test
Evaluates mobility and balance by timing how long it takes a participant to rise from a chair, walk three meters, turn, and sit down. Longer times suggest a higher fall risk, especially in older adults.
Time frame: Baseline Timed Up and Go (TUG) Test
30-Second Sit-to-Stand Test
Counts how many times a participant can stand from sitting in 30 seconds. It assesses lower body strength and endurance, with higher counts indicating better functional ability.
Time frame: Baseline 30-Second Sit-to-Stand Test
Falls Efficacy Scale-International (FES-I)
A scale that measures the concern about falling during daily activities. Scale: The FES-I includes 16 items scored from 16 to 64, where higher scores indicate greater concern about falling.
Time frame: Baseline Falls Efficacy Scale-International (FES-I)
Body weight measurement
Measure the body weight of participants using a calibrated scale. Unit of Measure: Kilograms or pounds.
Time frame: Baseline body weight measurement
Height Measurement
Record the participant's height using a stadiometer. Unit of Measure: Meters or centimeters.
Time frame: Baseline height measurement
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