With the ageing population of the world, Osteoarthritis (OA) is an ever-present condition that affects more and more people each year. With this increasing affected population, the risk of falls or OA related injuries is also something that is growing more present in each passing year. Roughly 1 in 3 people over the age of 65 will fall each year in European countries, and anywhere between 25% and 60% of falls will result in injury (Ikutomo et al, 2019).  Some of the most prevalent risk factors for falls are muscle weakness, poor balance, and gait deficiencies, all of which can be adversely affected by the presence of the Osteoarthritis. Exercise has long been established as an effective intervention for both OA, and patients who are deemed to be a fall risk. Interventions such as resistance training, balance training, or even general exercise such as walking, have all been shown to have positive influence over these symptoms, and this blog post aims to guide patients to be able to identify the rehabilitation plan that is best suited to them and their needs.

One of the reasons that Osteoarthritis can cause an increase in fall risk, is because as the condition develops in the hip and knee, it can cause reduced toe clearance, which means that gait and obstacle avoidance can become more challenging. A 2013 study performed by Ng and Tan, found that walking specific exercise programs and other exercises such as Tai-Chi were shown to have a positive in strength, balance, and patient reported fall confidence. They also found that water-based exercise programs had a positive effect on balance and coordination, but findings regarding strength and gait improvements were somewhat more unclear. 

Balance training has long been established as an important component in training plans aimed at decreasing fall risk, however in patients with Osteoarthritis, 1 in 3 patients tend to be treated without any specific balance training (Anderson et al, 2019). With the clear cut and well researched correlation between OA and increased fall risk, it seems that specific balance training may be a somewhat underutilised tool in the formulation of an effective rehab plan. In patients with an early diagnosis of Osteoarthritis, balance training could also be used as a preventative measure to help prevent patients from becoming fall risks in the future. 

Strength training has been long established as an effective treatment method for many of the conditions that can lead to increased fall risk, such as osteopenia, sarcopenia, and osteoarthritis. A 2008 study performed by Jan et al, compared the effects of high intensity vs low intensity strength training on both pain and function of patients with knee OA. The study found that higher intensity strength training yielded consistently greater results in lessening strength and improving function of these patient populations.

The Otago Fall Prevention Program was developed in Otago, New Zealand, as its name would suggest, as an intervention aimed specifically at reducing the likelihood of suffering falls. The program consists of a combination of strength, balance, and gait training. The Otago Fall Prevention Program has been shown to be significantly effective in improving balance and gait, and also increasing strength of the lower limb (Patel & Pachpute, 2015). In doing so, the program ultimately has a positive effect on lowering the fall risk of patients in the elderly population, whether they are suffering from OA or not. The program is also easily comprehensible by patients, so aside from being used in the day to day clinical setting, it is also prescribed as a home exercise program for patients in need of fall prevention training.

Exercise therapy has long been considered an effective and important treatment for the prevention of falls in patients who suffer from arthritis. Depending on patient specific needs and symptoms, some exercise based interventions may prove more helpful than others. In the case that a patient has multiple factors affecting their symptoms or leading to a greater risk of falls, combination interventions such as the Otago Fall Prevention Program may prove more useful than singular interventions alone.

If you suffer from Osteoarthritis and you notice any pain or reduced range of motion from a fall, contact one of our physios at PMC Physiotherapy Dunboyne and get it checked out. We combine the latest hands-on treatment techniques with rehabilitative exercises, focusing on correcting poor movement patterns and providing lifestyle advice for optimal recovery. Book your appointment today.