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Rheumatology Advance Access published online on November 30, 2004
Rheumatology, doi:10.1093/rheumatology/keh493
Rheumatology © British Society for Rheumatology 2004; all rights reserved
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Received September 15, 2004
Accepted October 22, 2004

Concise report

Effect of experimentally induced knee pain on standing balance in healthy older individuals

K. L. Bennell 1* and R. S. Hinman 1

1 Centre for Health, Exercise and Sports Medicine, School of Physiotherapy, The University of Melbourne, Australia

* To whom correspondence should be addressed.
K. L. Bennell, E-mail: k.bennell{at}unimelb.edu.au


  Abstract

Objective. Standing balance is impaired in older individuals with knee pain. The extent to which this impairment is due to the effects of pain itself or other pathophysiological aspects related to the underlying musculoskeletal condition causing the pain is unclear. To isolate the influence of pain, this study evaluated the effect of experimentally induced knee pain on standing balance in healthy older individuals.

Methods. We used a repeated-measures, within-subject design involving 12 healthy individuals aged 50-60 yr and with no history of knee pathology. Balance was tested during two randomly allocated experimental conditions: (i) control and (ii) knee pain induced by injection of hypertonic saline into the infrapatellar fat pad. Balance was measured using a computerized force platform under static and dynamic conditions as well as via the functional step test.

Results. Standing balance was not significantly altered by experimentally induced acute knee pain, nor was there any relationship between the severity of reported pain and balance scores.

Conclusions. Impairments in balance associated with knee conditions such as osteoarthritis may be due to factors other than the sensation of pain. Thus, strategies designed to reduce pain in treatment of knee pathology may not necessarily lead to improvements in balance. Further research is required to determine the exact causes of balance impairment in individuals with knee joint pain and pathology.

Keywords: Knee joint; Balance; Nociception; Experimental pain; Hypertonic saline.
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