# The Role of Periarticular Knee Muscle Torques in Ensuring the Body Balance of Older Adults with Balance Disturbances

## TL;DR

This study shows that knee muscle strength, especially extensors, plays a key role in balance for older adults with balance issues.

## Contribution

The study identifies knee extensor muscle torques as a novel predictor of balance disorders in older adults.

## Key findings

- Knee extensor muscle torques significantly predict changes in the center of pressure in older adults with balance disorders.
- Participants with balance disorders showed significant differences in DHI, GDS, FES-I, and POMA test results.
- Diff SMM, derived from skeletal muscle mass, differed significantly between groups with balance disorders and controls.

## Abstract

Background: The role of the periarticular muscles of the knee joint in ensuring body balance is still ambiguous. Therefore, we conducted clinical and biomechanical assessments on 52 older adults (36 women and 16 men, age of 67.58 ± 7.30 years, body weight of 75.10 ± 13.42 kg, and height of 163.92 ± 8.80 cm) to determine the role of the knee muscles in balance maintenance. Methods: The clinical examination included the Dizziness Handicap Inventory (DHI), the Geriatric Depression Scale (GDS), the Performance-Oriented Mobility Assessment (POMA), the Functional Reach Test (FRT), the Falls Efficacy Scale—International (FES-I), and bioimpedance parameters (skeletal muscle mass—SMM—and its derived parameter—Diff SMM). The biomechanical assessment involved parameters that characterize muscle torques of knee joint extensors and flexors in isokinetic and isometric conditions, as well as changes in the centre of pressure (COP) position while standing with eyes open and closed. Results: Based on treatment history and DHI results (>10 points), 26 participants were identified as having balance disorders, while the remaining participants formed the control group. Statistical analysis was performed to determine differences between the groups. The groups significantly differed in terms of the results obtained from the DHI (p < 0.001) and GDS (p = 0.04) questionnaires as well as FES-I (p < 0.001) and POMA (p = 0.002) tests. While SMM (p = 0.012) was similar in the groups, Diff SMM (p = 0.04) significantly differed. The multiple regression analysis confirmed the knee joint extensor parameters’ significant role in predicting the COP path (p = 0.03 and p = 0.04 for two assumed models). Conclusions: The obtained results proved that the muscle torques of knee extensors can be used in the diagnostic process of older patients with balance disorders, indicating possible rehabilitation directions.