Discriminative ability of functional performance tests on risk of falling among older adults with knee osteoarthritis: A cross-sectional study

Identifying fall risk among older adults with knee osteoarthritis (OA) is essential for targeted prevention. Although functional tests assessing mobility, strength, and balance are widely used, no consensus exists on the most effective test to identify fall risk in this population. This study aimed to compare functional performance tests and fall risk between older adults with and without knee OA, compare the tests in older adults with and without fall risk in both groups, and determine cutoff scores for these tests to identify fall risk among older adults with knee OA. This cross-sectional study included 106 participants aged ≥ 60 years (53 in each group). The participants completed the Thai falls risk assessment test and performed 5 functional performance tests, including the timed-up and go test (TUGT), functional reach test, alternate-step test (AST), 5 times sit-to-stand test (FTSST), and 10-meter walk test (10MWT). The independent t-test and Mann-Whitney U test were used to compare outcomes, and receiver operating characteristic curves were used to identify the optimal cutoff scores. Older adults with knee OA had a higher fall risk and performed significantly worse on the TUGT, AST, FTSST, and 10MWT than those without knee OA. The TUGT and AST scores effectively distinguished the fall risk between older adults with and without knee OA. cutoff scores of 10.5 and 24.5 seconds for the TUGT and AST, respectively, had acceptable area under curve values, effectively discriminating fall risk among older adults with knee OA. Older adults with knee OA exhibit a higher risk of falls and reduced functional abilities. The TUGT and AST may serve as useful fall-risk screening tools among this population.