Postural control in individuals with knee osteoarthritis:from patient-reported outcomes to kinetic analysis
(2026)
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- Authors
- Supervisors
- Schepens, Bénédicte
- Abstract
- Knee osteoarthritis is a prevalent musculoskeletal condition that substantially impairs functional mobility and postural control during everyday activities. Difficulties in rising from a chair, sitting down, and initiating gait often persist even when pain is relatively controlled, suggesting alterations in balance regulation that are not fully captured by conventional clinical assessments. A comprehensive understanding of these difficulties requires the integration of self-reported outcomes, functional performance tests, and objective biomechanical measures. The overall aim of this thesis was to investigate postural control in individuals with knee osteoarthritis using a multi-dimensional approach combining patient-reported outcomes, clinical performance tests, and kinetic analyses of functional transitions. Three complementary studies were conducted. The first study focused on the cross-cultural adaptation and psychometric validation of the Vietnamese version of the Knee Injury and Osteoarthritis Outcome Score (KOOS-V). The KOOS was translated and culturally adapted following established guidelines, and its measurement properties were evaluated in individuals with knee osteoarthritis. The KOOS-V demonstrated good to excellent internal consistency, test–retest reliability, and construct validity, supporting its use for clinical and research assessment of knee-related symptoms and function in Vietnam. The second study examined postural control during bipodal transitions by analysing the kinetics of Sit-to-Stand and Stand-to-Sit tasks in individuals with knee osteoarthritis, age-matched healthy older adults, and healthy young adults. The vertical component of the ground reaction force recorded from dual force plates was used to identify key temporal events and movement phases. Compared with healthy participants, individuals with knee osteoarthritis exhibited longer movement durations, altered force modulation, and increased inter-limb asymmetry, particularly during phases requiring deceleration and stabilisation. Correlations were observed between kinetic variables, performance on the Five-Times Sit-to-Stand Test, and KOOS-V scores, highlighting links between objective balance control and perceived functional limitations. Stand-to-Sit emerged as a task with pronounced demands on eccentric control and postural regulation. The third study investigated postural control during the bipodal-to-unipodal transition of gait initiation. Using a four-phase framework based on centre-of-pressure trajectories, anticipatory postural adjustments and loading patterns were analysed during gait initiation with both the preferred and non-preferred leading leg. Individuals with knee osteoarthritis demonstrated prolonged anticipatory phases, reduced loading dynamics, and altered asymmetry patterns compared with healthy older and young adults. These adaptations reflected a stability-oriented strategy and were associated with balance performance and self-reported function. Together, these studies provide an integrated description of postural control modifications in knee osteoarthritis across key functional transitions. By combining validated patient-reported outcomes with kinetic analyses and clinical performance tests, this thesis highlights specific phases and tasks that are particularly sensitive to balance impairments. These findings support the inclusion of both rising-up and going-down tasks, as well as gait initiation, in the assessment of postural control and may inform targeted rehabilitation strategies aimed at improving functional stability in individuals with knee osteoarthritis.
- Affiliations
Citations
Lê, V. (2026). Postural control in individuals with knee osteoarthritis:from patient-reported outcomes to kinetic analysis. https://hdl.handle.net/2078.5/272455