The Bioscan · Jun 25, 2026

Comparative Effects of Strength and Balance Training on Fall- Risk Indicators in Older Adults with Knee Osteoarthritis: A Randomized Trial With 9-Month Follow-Up

By Kumar A, KHAN J, Lohar DD et al.

Background: Knee osteoarthritis is associated with pain, lower-limb weakness, impaired proprioception,altered gait, and increased fall risk. Strength and balance exercises address different mechanisms, but directcomparative evidence with longer follow-up remains limited.Objective: To compare the effects of progressive lower-limb strength training and progressive balancetraining on functional mobility, postural control, concern about falling, and composite fall risk in older adultswith knee osteoarthritis.Methods: This prospective randomized comparative trial included 60 adults aged 50-75 years with clinicallyand radiologically diagnosed knee osteoarthritis. Participants were allocated equally to strength training(n=30) or balance training (n=30). Both groups completed 24 supervised sessions over 6 weeks. Outcomeswere assessed at baseline, 3 months, and 9 months using the Timed Up and Go test (TUG), Berg BalanceScale (BBS), Falls Efficacy Scale-International (FES-I), and Falls Risk Assessment Tool (FRAT). Between-group mean differences, 95% confidence intervals (CIs), and Hedges g were calculated.Results: Baseline outcome values did not differ significantly. At 9 months, balance training was superior forTUG (10.36+/-1.67 vs 13.19+/-1.29 s; mean difference [MD] -2.83 s, 95% CI -3.60 to -2.06; p<0.001), BBS(47.60+/-3.32 vs 44.40+/-2.28; MD 3.20, 95% CI 1.72 to 4.68; p<0.001), FES-I (22.20+/-4.74 vs 25.67+/-3.12; MD -3.47, 95% CI -5.55 to -1.39; p=0.002), and FRAT (2.93+/-1.23 vs 3.87+/-0.90; MD -0.94, 95%CI -1.50 to -0.38; p=0.001). Hedges g ranged from 0.85 to 1.87 in magnitude.Conclusion: Both interventions improved fall-risk indicators, but progressive balance training producedgreater and more sustained benefits. Rehabilitation for older adults with knee osteoarthritis should includechallenging static and dynamic balance activities, supported by lower-limb strengthening.

doi.org/10.63001/tbs.2026.v21.i02.s.i(2).pp21896-21907 Open access Interventions