Balance performance in older adults with hip osteoarthritis: A systematic review

Background: The hip is one of the most common joints affected by osteoarthritis (OA) and it has been identified as a key risk factors for falls. Physical impairments associated with OA, such as joint pain, muscle weakness, joint stiffness and sensory dysfunction, can all negatively affect balance and increase risk of falling. Question: Is balance performance altered in older adults with hip osteoarthritis? To determine whether static, dynamic, reactive or functional balance performance is altered in older people with hip osteoarthritis. Methods: Quantitative measures of postural control, including clinical and lab-based assessment of static, dynamic, reactive and/or functional balance performance, compared with a healthy control group or to the asymptomatic limb. Results: A total of 5407 articles were identified and 14 papers were included (10 with standardised mean different (SMD) data, four without SMD data). Based on data from single studies, there were medium/large effects for increased medio-lateral displacement when standing with eyes open, increased anterior-posterior and total sway path length when standing with eyes closed, greater overall instability when standing on an unstable surface, and increased displacement toward the stance leg in a lateral step in hip OA compared with controls. Conclusion: Balance impairments were identified in some measures, limiting the conclusions as to whether balance deficits are a problem in hip OA. Inconsistent findings suggest that balance may not be a primary contributor to increased falls risk in older adults with hip OA. Other factors, such as musculoskeletal deficits, may contribute to higher falls rate in this population.