Derivation of a clinical prediction rule to determine fall risk in community-dwelling individuals with knee osteoarthritis: a cross-sectional study



We derived a clinical prediction rule (CPR) to determine fall risk. The probability of falls increased, with positive likelihood ratio being 17.8 and post-test probability (positive predictive value) being 88.2%, in cases where the CPR score was 2 points. Our CPR could be a useful screening test to detect fall risk probability.


We aimed to examine the risk factors for falls in individuals with knee osteoarthritis (OA) and derive a clinical prediction rule (CPR) to determine fall risk.


Eighty-one individuals with medial compartment knee OA were included. The outcome was whether the participants had a self-reported fall within the past 1 year of this study being conducted. The collected data included sex, age, body mass index, Kellgren-Lawrence grade, lesion type (bilateral or unilateral knee OA), pain (rated using the visual analog scale), muscle strength test of the quadriceps femoris, one-leg standing test (OLST), five times sit-to-stand test (FTSST), and 5-m walk test, which were used in binomial logistic regression analysis. The outcome measure of the analysis was whether the study participants belonged to a fall or non-fall group. Receiver operating characteristic (ROC) analysis was performed for the outcome measurements, and the factors were selected by binomial logistic regression analysis. Then, a CPR to determine fall risk was extracted, and its diagnostic characteristics were calculated.


Binomial logistic regression analysis showed that the OLST and FTSST were significant. ROC analysis showed that the cut-off values of the OLST and FTSST were 5.3 s and 7.9 s, respectively. The post-test probability (positive predictive value) increased to 88.2% (positive likelihood ratio = 17.8) when the OLST and FTSST were both positive (the CPR score was 2 points).


The CPR obtained from this study would be useful as a screening test to detect the fall risk probability in individuals with knee OA.

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Correspondence to Tetsuya Amano.

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All study participants were informed of this study and provided written informed consent. This study was approved by the Research Ethics Committee of Tokoha University (approval no. R-2018-505H).

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Amano, T., Suzuki, N. Derivation of a clinical prediction rule to determine fall risk in community-dwelling individuals with knee osteoarthritis: a cross-sectional study. Arch Osteoporos 14, 90 (2019).

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  • Prognosis prediction
  • Clinical prediction rule
  • Osteoarthritis
  • Knee
  • Falls