Force Platform Assessment of Postural Balance in Knee Osteoarthritis – A Systematic Review

Osteoarthritis (OA) is the most common form of progressive joint disease. It presents with pain, stiffness and swelling which leads to muscle weakness and reduced physical function. The involvement of lower limb joints leads to deterioration of proprioception and predisposes to postural instability. Postural sway assessment is an integral component in the institution of goal-oriented treatment for OA. Postural sway assessment consists of various parameters such as antero-posterior amplitude, medio-lateral amplitude, total sway area, and center of pressure velocity. The study aims to systematically appraise the current evidence of different postural sway parameters from force plates and their association with knee OA. A literature search was conducted through PubMed, Scopus, and Web of Science databases. One-hundred-fifteen articles were identified for screening, of which 10 studies met the inclusion criteria. The methodological quality of the study was assessed by two independent reviewers using Newcastle-Ottawa Quality Assessment Scale (NOS). Five out of nine studies showed significant anterior-posterior deviation, five out of six studies showed significant center of pressure deviation and three out of nine studies showed significant medial-lateral deviation. This review indicates that patients with knee OA sway more in anterior-posterior direction as compared to medio-lateral direction and can be considered as a key finding while assessing knee pain.