BACK

Balance is one skill-related component of fitness that is often limited in patients with knee Osteoarthritis. Control of balance is quite complex but is dependent on vestibular, visual and somatosensory inputs; central processing; and the appropriate motor response. Severe pain, articular damage and quadriceps muscle weakness associated with OA of the knee contribute to postural instability via loss of motor control and proprioceptive acuity. A treatment that can relieve knee pain in patients with OA may result in greater weight distribution, which, potentially, could improve static and dynamic postural stability. This study examines the effects of 30 days of treatment with a topical cream consisting of a blend of cetylated fatty acids on static postural stability and plantar pressure in patients with knee OA.

METHODS AND MATERIALS

This study examined the effects of 30 days of treatment with a topical cream consisting of cetylated fatty acids on static postural stability and plantar pressures in patients with OA of one or both knees.

40 patients diagnosed with knee OA by a physician were randomly assigned to one of two topical treatment groups in a double-blind manner 1) CFA (n=20) or 2) placebo (n=20). Participants were tested on two occasions 1) at baseline and 2) following a 30-day treatment period consisting of cream application twice per day.

Assessments included 20 and 40-second quiet standing protocols on a force plate to measure the centre of pressure, total excursion length, centre of pressure velocity, and rearfoot and forefoot plantar pressure distribution. These measurements allowed the researchers to assess postural stability.

RESULTS AND CONCLUSIONS
The key finding was that 30 days of treatment with a topical cream consisting of CFA significantly improved standing postural stability in patients with knee OA. Specifically, the treatment resulted in reduced centre of pressure excursion length and velocity during 40 seconds of quiet standing. The results of this study support the findings of previous studies which have also demonstrated the efficacy of treatment with a topical cream consisting of a blend of CFA for reducing pain and improving functional performance in patients with knee OA.

In this study it appeared that the greater postural stability observed in patients with OA was a result of pain relief. Pain has been shown to reflexively inhibit muscle activation around the knee as well as other mechanisms of standing, normal gait, or both.

PRACTICAL APPLICATIONS
These data indicate that 30 days of treatment with a topical cream consisting of CFA improves static postural stability in patients with knee OA presumably due to pain relief during quiet standing. Such over the counter treatment may help improve the exercise trainability of people with OA in exercise programs.

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