Fall Risk and Physical Function Among Patients with Osteoarthritis : a cross-sectional study

Abstract

Background: Osteoarthritis (OA) is one of the leading causes of disability worldwide, particularly affecting older adults. Knee osteoarthritis results in pain, stiffness, and reduced physical function, which increases the fall risk among osteoarthritis patients. Falls lead to a decrease in physical function and occupational participation in daily life. This study helps to bridge this research gap by assessing the interactions between these factors. The role of an occupational therapist in increasing confidence in fall prevention is undeniable. It helps maximize the ability to participate in occupational activities that are meaningful to the participants. Aim: This study aimed to understand the relationship between fall risk and physical function among osteoarthritis patients. Methods: This study followed a cross-sectional quantitative research design. Participants were recruited using purposive sampling from rehabilitation services at the Centre for the Rehabilitation of the Paralysed (CRP). A total of 109 patients diagnosed with knee OA, aged 30-81 years participated in this study. Data were collected through a face-to-face interview using validated assessment tools. Western Ontario and McMaster University Osteoarthritis Index scale (WOMAC) was used to evaluate pain, stiffness, and physical function. To assess fall risk, the Modified Fall Efficacy Scale (MFES) consists of 14 items measuring an individual’s confidence in performing daily activities without falling. Participants scoring below 8 were categorized as "fearful" of falling, while those scoring 8 or above were classified as "fearless." determined an individual's placement into the fearful and fearless category among osteoarthritis participants. Statistical Package of Social Science (SPSS) 22 version was used to conduct the descriptive analysis. Result: The average age of participants was 54.25 ± 11.14 years with females making up 59.6% of the participants. Among the participants, 42.2% reported moderate pain, and 33.0% suffered from severe pain. Stiffness levels were generally low at 65.1% indicating no stiffness. In terms of physical function, 48.6% faced moderate challenges in daily activities. The median WOMAC score was 44 which reflects a moderate severity of OA among the participants. Regarding fall risk, 35.8% of participants expressed fear of falling and 64.2% felt confident in performing activities. The chi square test also indicated a significant relationship between pain and physical function (p = 0.001), whereby greater pain intensity was associated with more severe functional deficits. Fall risk was also significantly related to physical function (p = 0.001), with less confidence in movement associated with greater restrictions in activity. There were no significant relationships between fall risk and demographic variables of age (p = 0.133) or gender (p = 0.917). Conclusion: The findings of this study indicate that pain severity and reduced confidence in movement significantly impact physical function and increase fall risk among OA patients. This underscores the need for targeted interventions, including pain management strategies, balance training, and assistive devices, to enhance functional independence and reduce fall risk in OA patients. Occupational therapists play a crucial role in designing rehabilitation programs and improving patients' quality of life. Future research should explore longitudinal outcomes and intervention effectiveness to develop comprehensive management strategies for OA patients. Keywords: Adults, Osteoarthritis, Pain, Stiffness, Physical function, Fall risk, WOMAC, MFES, Occupational Therapy