PAIN JOINTS SPINE · Aug 19, 2026
Long-Term Comparative Effects Of Strength And Balance Training On Fall Risk In Elderly Patients With Knee Osteoarthritis: a Statistical Outcome Analysis
By Kumar A, KHAN J, Vyas D et al.
Background: Falls in older adults with knee osteoarthritis (OA) arise from interacting deficits in muscle strength, proprioception, dynamic balance, gait control and confidence. The present analysis was designed to emphasize the statistical trajectory and clinical interpretation of outcomes after strength training versus balance training. Objective: To compare the magnitude, timing and long-term persistence of changes in functional mobility, balance, fear of falling and composite fall risk after two supervised exercise programmes. Methods: Sixty adults aged 50–75 years with clinically and radiologically diagnosed knee OA were randomized equally to a strength training group (STG) or balance training group (BTG). Both groups completed 24 supervised sessions over 6 weeks. Outcomes were Timed Up and Go (TUG), Berg Balance Scale (BBS), Falls Efficacy Scale-International (FES-I) and Fall Risk Assessment Tool (FRAT), measured at baseline, 3 months and 9 months. Reported group means, standard deviations and between-group p values were retained from the dissertation. For this paper, percentage change and exploratory 9-month between-group standardized effect sizes were additionally calculated from the reported summary statistics. Results: Baseline scores were statistically comparable for TUG (p=0.196), BBS (p=0.164), FES-I (p=0.080) and FRAT (p=0.593). At 3 months, BTG was superior for TUG (14.18±0.94 vs 15.08±1.07 s, p=0.001), BBS (43.60±2.28 vs 39.77±1.77, p<0.001) and FES-I (28.20±3.83 vs 30.53±2.67, p=0.008), while FRAT had not yet separated significantly (5.00±1.29 vs 5.47±0.73, p=0.088). By 9 months, all four outcomes favored BTG: TUG 10.36±1.67 vs 13.19±1.29 s (p<0.001), BBS 47.60±3.32 vs 44.40±2.28 (p<0.001), FES-I 22.20±4.74 vs 25.67±3.12 (p<0.001), and FRAT 2.93±1.23 vs 3.87±0.90 (p=0.001). Beneficial baseline-to-9-month change was larger in BTG for TUG (43.1% vs 26.6%), BBS (34.5% vs 22.7%), FES-I (41.6% vs 29.3%) and FRAT (61.4% vs 48.6%). Exploratory 9-month standardized between-group effects were large to very large (absolute Cohen d 0.86–1.90). Conclusion: Both programmes were associated with sustained improvement, but balance training demonstrated earlier separation on mobility, balance and fear of falling and a broader long-term advantage across every fall-risk domain. The pattern suggests that task-specific postural challenge and stepping practice contributed benefits beyond strength gains alone.