Type of Article:  Original Research

Volume 8; Issue 2 (April 2020)

Page No.: 3398-3406

DOI: https://dx.doi.org/10.16965/ijpr.2020.105


Varsha. Solanki *1, Saraswati. Iyer 2.

*1 Post-graduate Research Student, P.T. School and Centre, Seth Gordhandas Sunderdas Medical College & King Edward Memorial Hospital, Parel, Mumbai, India.

2 Professor and Head of Department, P.T. School and Centre, Seth Gordhandas Sunderdas Medical College and King Edward Memorial Hospital, Parel, Mumbai, India.

Corresponding Author: Dr. Varsha. Solanki (PT), P.T. School and Centre, Seth Gordhandas Sunderdas Medical College & King Edward Memorial Hospital, Parel, Mumbai-400 012, India. E-Mail: varshasolanki.vs18@gmail.com


Background: Balance in the human body is maintained by the coordinated integration of sensory input from somatosensory, vestibular and visual system. This coordinated response to stimuli must be transmitted to appropriate muscles to maintain or to correct balance. Both static and dynamic stabilizers provide support to the normal knee joint where static stabilizers include ligament, meniscus and joint capsule which provide stabilization to the joint. Altered response in these sensory inputs may affect balance. Proprioceptive feedback is received from the sensory receptors present in the joint to maintain knee joint position, which gets altered due to microtrauma in the aging process, which thus affects balance. In elderly, this loss of balance is correlated with increased risk of falls. So, it is important to study the correlation between static balance and knee proprioception in elderly.

Purpose of the study: To understand the correlation of static balance with knee proprioception.

Methodology: It was an Observational cross- sectional study in which 70 subjects were enrolled as per the inclusion and exclusion criteria, after which a written informed consent was taken. Knee proprioception error was assessed in standing position using a goniometer. Static Balance was assessed using Tandem Stance Time.

Results: The study showed negative correlation between Right knee proprioception error and tandem stance time, r= -0.1207 and left knee proprioception error and tandem stance time, r= -0.1222.

Conclusion:  Thus, the study concluded that there is negative correlation between knee proprioception error and static balance, i.e. lesser the knee proprioception error better is the static balance.

KEY WORDS: Static Balance, Knee proprioception error, Tandem Stance Time.


  1. Cynthia c. Norkin, Pamela K. Levangie. Joint Structure and Function- A comprehensive Analysis. 5th Edition, Jaypee Brothers Medical Publishers (P) Ltd,2011, p395-439
  2. Carolyn Kisner, Lynn Allen Colby. Therapeutic Exercise- Foundation and Techniques. 6th Edition, Jaypee Brothers Medical Publishers (P) Ltd, 2012, p765-770
  3. Dhwani Jain, Mugdha Oberoi, Veena Krishnanand. Correlation of static and dynamic balance with knee proprioception in normals. Int J Physiother Res 2017;5(4):2215-2219
  4. Reza Bhaktiari. Evaluation Of static and dynamic balance and knee proprioception in young professional soccer players. Annal of Biological research, 2012;3(6):2867-2873
  5. Dena Gardiner: The Principles of Exercise Therapy. 4th Edition, CBS Publishers & Distributors Pvt. Ltd., p2-6.
  6. A. Umphred, Neurological Rehabilitation, 5th edition, p732-739.
  7. Madhavi Lokhande and Jaimala Shetye, Assessment of knee joint proprioception in weight bearing and non-weight bearing positions in normal subjects. JKIMSU 2013;2.
  8. Fernando Ribeiro, Jose Oliveira. Aging effects on joint Proproception: the role of physical activity in proprioception preservation, Eur Rev Aging Phys Act 2007;4:71-76.
  9. Ribeiro F, Oliveira J. Factors influencing proprioception: what do they reveal?. chapter; 2011 Sep 9.
  10. Woollacott MH, Shumway-Cook A, Nashner LM. Aging and posture control: changes in sensory organization and muscular coordination. Int J Aging Hum Dev 1986;23(2):97–114.
  11. Gillian Hawker, Samra Mian, et al. Measures of Adult pain, Arthritis Care and Research, November 2011;63(11):S240-S252.
  12. Steven Milanese; Susan Gordon; School of Public Health. James Cook University, Reliability and validity of universal goniometer 2016.
  13. Lucie Brosseua, Sonia Gringras: Intra and intertester reliability and criterion validity of the parallelogram and universal goniometers for measuring maximum active knew flexion and extension of patients with knee restrictions. Archives of physical medicine and Rehabilitation, March 2001;82(3):396-402.
  14. Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, Leirer VO: Development and validation of a Geriatric Depression Screening Scale: A preliminary report. J Psychiatr Res. 1982-1983;17(1):37-49.
  15. McLennan SN, Mathias JL, Brennan LC, Stewart S: Validity of Montreal Cognitive Assessment (MoCA) as a screening test for mild cognitive impairment (MCI) in cardiovascular population. JGeriatr Psychiatry Neurol. 2011 March;24(1):33-8.
  16. Valcour VG, Maaki KH, Kurb JD, Blanchette PL: The detection of dementia in primary care setting. Arch Inter Med. 2000 Oct23;160(19):2964-8.
  17. Pincivero DM, Bachmeier B, Coelho AJ: The effect of joint angle and reliability on knee proprioception. Med Sci Sports Exerc, 2001 Oct;33(10):1708-12.
  18. Gökben Hızlı Sayar, Hüseyin Ünübol Assessing proprioception- The Journal of Neurobehavioural Sciences 2017;4(1).
  19. Assessment protocols for Standardized Balance Tests.
  20. Jack Guralnik, Luigi Ferrucci, Eleanor Simonsick, Marcel Salive, Robert Wallace: Lower Extremity Function in persons over the age of 70 years a predictor of subsequent disability. The New England Journal of Medicine, 1995;332(9):556-561.
  21. Guralnik, Ferrucci, Glynn, Berkman,Blazer, Scherr, Wallace (1994) A short physical performance battery assessing lower extremity function: Association with self-reported disability and prediction of morality and nursing home admission. Journal of Gerontology, 1994;49(2):M85-M92.
  22. Tyson SF, DeSouza LH, Reliability and validity of functional balance tests post stroke. Clin Rehabil. 2004 Dec;18(8):916-923.
  23. Shirley Ryan Abilitylab- Sharpened Romberg
  24. Elizabeth Hile, Jennifer Brach, Subashan Perera, David Wert, Jessie M, VanSwearingen, Stephanie A, Studenski, Interpreting the need for Initial Support to perform Tandem Stance Tests of Balance: Phys Ther. 2012 Oct; 92(10): 1316-1328.
  25. Stoffregen TA, Riccio GE, An Ecological theory of orientation and the vestibular system. Psychol Rev;Database-Psyc Articles,1988;95(1);3–14.
  26. Kelvin S.Oie , Kim Kiemel , John J Jeka:Multisensory fusion:simultaneous reweighting of vision and touch for control of human posture,Cognitive Brain research ; 2002;14(1);164 – 176.
  27. Liana Nafisa Saftari and Oh-Sang Kwon. Ageing vision and falls: a review, Journal of Physiological Anthropology (2018) 37:11.
  28. Kararizou E, Manta P, Kalfakis N, Vassilopoulos D. Morphometric study of the human muscle spindle. Anal Quant Cytol Histol 2005;27(1):1-4.
  29. Daniel J. Goble, James P. Coxon, Nicole Wenderoth, Annouchka Van Impe, Stephan P. Swinnen Proprioceptive sensibility in the elderly: Degeneration, functional consequences and plastic-adaptive processes Neuroscience and Biobehavioral Reviews 2009;33:271–278.
  30. Susan O’Sullivan, Physical Rehabilitation, Fifth Edition, Chapter 18, Page 1000.
  31. Marjorie Hines Woollacott Systems Contributing to Balance Disorders in Older Adults Journal of Gerontology: Medical Sciences 2000;55A(8):M424–M428.
  32. Tanu Khanna, Sandeep Singh. Effect of Gaze Stability Exercises on Balance in Elderly, IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) 2014;13(9) Ver. I:41-48.
  33. Paquette, and J. Fung, Old age affects gaze and postural coordination, Gait & Posture, 2011;33(2):227-32.
  34. Christopher K. Zalewski Aging of the Human Vestibular System Semin Hear. 2015 Aug; 36(3):175–196.
  35. Carpenter, Cara; Stanford, Megan; and Putnam, Katie. A Comparison of Eyes Open Versus Eyes Closed Balance Training. School of Physical Therapy. 2001;161.
  36. Haibach P, Slobounov S, Newell K. Egomotion and vection in young and elderly adults. Gerontology. 2009;55:637–43.
  37. Sundermeier L, Woollacott M, Jensen J, Moore S. Postural sensitivity to visual flow in aging adults with and without balance problems. J Gerontol Med Sci. 1996;51A:M45–M52.
  38. Klein BEK, Klein R, Lee KE,Cruickshanks KJ. Performance-based and self-assessed measure of visual function as related to history of falls, hip fractures and measures of gait time. Ophthalmology 1998 Jan;105(1):160-164.
  39. Nnodim JO, Yung RL. Balance and its Clinical Assessment in Older Adults – A Review. J Geriatr Med Gerontol 2015;1:003.
  40. Lexell J, Taylor CC, Sjöström M. What is the cause of the ageing atrophy? Total number, size and proportion of different fiber types studied in whole vastus lateralis muscle from 15- to 83-year-old men. J Neurol Sci 1988;84:275-294.
  41. Larsson L, Grimby G, Karlsson J. Muscle strength and speed of movement in relation to age and muscle morphology. J Appl Physiol Respir Environ Exerc Physiol 1988; 46: 451-456.
  42. Christopher J. Hasson, Richard E.A. van Emmerik, and Graham E. Caldwell. Balance Decrements Are Associated with Age-Related Muscle Property Changes. Journal of Applied Biomechanics, 2014;30:555-562.
  43. Onambele GL, Narici MV, Maganaris CN. Calf muscle-tendon properties and postural balance in old age. J Appl Physiol. 2006;100(6):2048–2056.
  44. Frey D, Schneider C, Xu L, Borg J, Spooren W, Caroni P. Early and selective loss of neuromuscular synapse subtypes with low sprouting competence in motoneuron diseases. J Neurosci. 2000;20(7):2534–2542.
  45. Hasson CJ, Caldwell GE. Effects of age on mechanical properties of dorsiflexor and plantarflexor muscles. Ann Biomed Eng. 2012;40(5):1088–1101.
  46. Hasson CJ, Kent-Braun JA, Caldwell GE. Contractile and non-contractile tissue volume and distribution in ankle muscles of young and older adults. J Biomech. 2011;44(12):2299–2306.
  47. Hasson CJ, Miller RH, Caldwell GE. Contractile and elastic ankle joint muscular properties in young and older adults. P LoS ONE. 2011;6(1):e15953
  48. Matheus M. Gomes, Júlia G. Reis, Thamires M. Neves, Marina Petrella, Daniela C.C. de Abreu Impact of Aging on Balance and Pattern of Muscle Activation in Elderly Women from Different Age Groups International Journal of Gerontology 2013;7:106-111.
  49. Aoyama M, Suzuki Y, Kuzuya M. Muscle Strength of Lower Extremities Related to Incident Falls in Community-Dwelling Older Adults. J Gerontol Geriat Res 2015;4:207.

Cite this article: Varsha. Solanki, Saraswati. Iyer. CORRELATION OF STATIC BALANCE WITH KNEE PROPRIOCEPTION IN ELDERLY. Int J Physiother Res 2020;8(2):3398-3406. DOI: 10.16965/ijpr.2020.105