Standing balance post total knee arthroplasty: sensitivity to change analysis from four to twelve weeks in 466 patients

Postural stability computerized evaluation in total knee arthroplasty

PURPOSE

To evaluate the balance in patients with total knee arthroplasty (TKA) and knee osteoarthrosis (KOA), measured by postural stability computerized evaluation (PSCE), and to evaluate the effect of post-TKA patients' characteristics in their performance on PSCE.

MATERIALS AND METHODS

An observational cross-sectional study was conducted in two sets of patients: (A) patients with KOA and primary TKA surgery scheduled and (B) patients who underwent primary TKA >9 months. Sociodemographic, radiographic, clinical and PSCE parameters (using the Biodex Balance System) were assessed.

RESULTS

Post-TKA patients placed more load on the replaced knee than the contralateral osteoarthritic knee (p = 0.027). They had less imbalance on the balance tests performed with the eyes open, on stable (p = 0.032), and unstable platforms (p = 0.022). These patients also showed better postural stability in monopodalic stance, both standing on the TKA (p = 0.010) and contralateral knee (p = 0.017). Age, weight, pain on the operated knee, extension deficit on the operated knee, and Berg Balance Scale scores on post-TKA patients were significantly associated with their performance on PSCE tests.

CONCLUSIONS

PSCE can be useful to quantify the balance of post-TKA and KOA patients.

Quiet standing postural control variables in subacute stroke: associations with gait and balance, falls prediction and responsiveness

PURPOSE

To examine the construct validity, predictive validity and responsiveness of standing centre of pressure variables in subacute stroke.

MATERIALS AND METHODS

Seventy-nine ambulatory individuals were assessed before inpatient rehabilitation discharge and three months later. Measures were: gait speed (6-metre walk), dynamic balance (step test), and quiet standing (Wii Balance Board). Centre of pressure speed, amplitude, standard deviation, root mean square, wavelet decomposition, and detrended fluctuation analysis were examined. Falls data were collected over a 12-month period post-discharge.

RESULTS

Moderate strength correlations (r = -0.505 to -0.548) with gait speed and step test scores were shown for 3/26 centre of pressure variables (mediolateral speed, low and moderate frequency wavelet). Twenty-two participants fell and the prediction was significant for gait speed and step test (IQR-odds ratio (OR) = 4.00 & 3.21) and 3/26 centre of pressure variables (mediolateral low-frequency wavelet: IQR-OR = 2.71; mediolateral detrended fluctuation analysis: IQR-OR = 3.06; anteroposterior detrended fluctuation analysis: IQR-OR = 2.71). Significant changes over time occurred for gait speed and step test scores and 20/26 centre of pressure variables.

CONCLUSIONS

Standing centre of pressure variables have limited validity to reflect dynamic balance and falls risk after stroke. Frequency and complexity measures warrant further exploration.Implications for rehabilitationOur findings indicate that quiet standing centre of pressure variables have limited validity to reflect dynamic balance tasks and predict falls after stroke.The mediolateral and higher frequency variables may be more strongly recommended than the commonly used total centre of pressure speed measure.Measures of signal frequency and complexity may provide insight into postural control mechanisms and how these change over time following stroke.

EVALUATION OF POSTURAL BALANCE INDICATORS IN HEALTHY INDIVIDUALS

OBJECTIVE

The aim: To determine and generalize the indicators of stabilometry in healthy individuals for their further use as a control group in studies of pathologies of the musculoskeletal system.

PATIENTS AND METHODS

Materials and methods: The study was conducted on a stable platform with biofeedback TYMO (Tyromotion). 30 male and female patients aged 18-25 years participated in the study. The following indicators were studied : distance traveled, medial-lateral deviation, anterior-posterior deviation, area of the statokinesiogram (COF), average speed, feedback system, Romberg index. Stabilometry was performed in a bipodal position, standing, in four functional positions: on a hard surface with eyes open and closed, on a soft surface with eyes open and closed.

RESULTS

Results: The reference values of the stabilometric parameters: the traveled distance, medio-lateral deviation, anterior-posterior deviation, the area of the statokinesiogram, the average speed, the feedback system, the Romberg index in healthy individuals aged 18-25 years were determined . When evaluating the feedback system, it was established that the visual component was 34% (32.0; 36.0), the vestibular 34% (32.0; 35.0), the somatosensory 33% (30.0; 36.0). The reflex-driven index was 0.55 (0.46, 0.62), the central nervous system (CNS)-driven index was 1.55 (1.25, 1.89) . The Romberg index M1/ M2 was 0.94 (0.78, 1.07), M2/M3 was 0.98 (0.86, 1.10).

CONCLUSION

Conclusions: The obtained indicators of movement in the sagittal plane, the area of the statokinesiogram, the average speed of movement, the feedback system (visual, vestibular, proprioceptive (somatosensory) components), the Romberg index (RI) can be considered reference values for healthy individuals aged 18-25 years .

Effect of balance training using virtual reality-based serious games in individuals with total knee replacement: A randomized controlled trial

BACKGROUND

Virtual reality (VR) and serious games (SGs) are widespread in rehabilitation for many orthopedic and neurological diseases. However, few studies have addressed the effects of rehabilitation with VR-based SGs on clinical, gait, and postural outcomes in individuals with total knee replacement (TKR).

OBJECTIVE

The primary objective was the efficacy of balance training using non-immersive VR-based SGs compared to conventional therapy in TKR patients on the Time Up and Go test. Secondary objectives included the efficacy on clinical, gait, and postural outcomes.

METHODS

We randomly allocated 56 individuals with unilateral TKR to the experimental group (EG) or control group (CG) for 15 sessions (45 min; 5 times per week) of non-immersive VR-based SGs or conventional balance training, respectively. The primary outcome was functional mobility measured by the Timed Up and Go test; secondary outcomes were walking speed, pain intensity, lower-limb muscular strength, independence in activities of daily living as well as gait and postural parameters.

RESULTS

We found significant within-group differences in all clinical outcomes and in a subset of gait (p<0.0001) and postural (p ≤ 0.05) parameters. Analysis of the stance time of the affected limb revealed significant between-group differences (p = 0.022): post-hoc analysis revealed within-group differences in the EG (p = 0.002) but not CG (p = 0.834). We found no significant between-group differences in other outcomes.

CONCLUSIONS

Balance training with non-immersive VR-based SGs can improve clinical, gait, and postural outcomes in TKR patients. It was not superior to the CG findings but could be considered an alternative to the conventional approach and can be added to a regular rehabilitation program in TKR patients. The EG had a more physiological duration of the gait stance phase at the end of the treatment than the CG.

CLINICALTRIALS

GOV: NCT03454256.

Reliability and Usability Analysis of an Embedded System Capable of Evaluating Balance in Elderly Populations Based on a Modified Wii Balance Board

This paper analyzes the reliability and usability of a portable electronic instrument that measures balance and balance impairment in older adults. The center of pressure (CoP) metrics are measured with a modified Wii Balance Board (mWBB) platform. In the intra- and inter-rater testing, 16 and 43 volunteers (mean 75.66 and standard deviation (SD) of 7.86 years and 72.61 (SD 7.86) years, respectively) collaborated. Five volunteer raters (5.1 (SD 3.69) years of experience) answered the System Usability Scale (SUS). The most reliable CoP index in the intra-examiner tests was the 95% power frequency in the medial-lateral displacement of the CoP with closed-eyes. It had excellent reliability with an intraclass correlation coefficient ICC = 0.948 (C.I. 0.862-0.982) and a Pearson's correlation coefficient PCC = 0.966 (p < 0.001). The best index for the inter-rater reliability was the centroidal frequency in the anterior-posterior direction closed-eyes, which had an ICC (2,1) = 0.825. The mWBB also obtained a high usability score. These results support the mWBB as a reliable complementary tool for measuring balance in older adults. Additionally, it does not have the limitations of laboratory-grade systems and clinical screening instruments.

Changes in postural sway during upright stance after short-term lower limb physical inactivity: A prospective study

Previous studies have reported that motor behavior is affected by short-term physical inactivity using cast immobilization; however, the effects of inactivity on postural sway are not well-understood. This study aimed to investigate the effects of short-term lower limb disuse on postural sway in the upright position after cast removal. Twenty-two healthy young adults were enrolled, and each participant’s lower limb on one side was fixed with a soft bandage and medical splint made from metal and soft urethane for 10 h. Fluctuations in the center of pressure (COP) were measured before and after immobilization; the total trajectory length, mean velocity, COP root mean square (RMS) area, mean medial-lateral (M-L) COP, and mean anterior-posterior (A-P) COP were selected as evaluation parameters. Compared with the postural sway before cast application, we noted an increase and shift (from the fixed to the nonfixed side) in the postural sway after cast removal. Our results therefore suggest that short-term disuse may cause acute changes in COP movements during quiet standing. Moreover, patients may maintain their standing posture by adopting a compensatory strategy involving lateral control, similar to individuals with stroke and patients who have undergone total knee arthroplasty.

Effectiveness of adding virtual reality to physiotherapeutic treatment in patients with total hip arthroplasty. A randomized controlled trial

OBJECTIVE

To determine the clinical effectiveness of adding virtual reality via the Nintendo Wii console and its Wii Balance Board to physiotherapy treatment in patients with total hip arthroplasty.

DESIGN

Randomized controlled trial.

SETTING

Clinical Hospital San Borja Arriaran, Santiago, Chile.

PARTICIPANTS

A total of 73 patients over 50 years of age with total hip arthroplasty were randomly allocated to two groups.

INTERVENTIONS

The control group (n = 37) received 6 weeks of physiotherapy treatment; the intervention group (n = 36) received the same treatment plus virtual reality exercises with the Nintendo Wii console.

OUTCOME MEASURES

The two groups were assessed at baseline and after the 6 weeks of treatment. The primary outcome assessed was the function with the WOMAC questionnaire. The secondary outcomes were the Berg Balance Scale, distance covered with the six-minute walk test, and difference in weight load on the lower extremities.

RESULTS

A total of 73 patients, 37 patients in the control group (20 women; mean age of 70.9 ± 9.16 years) and 36 patients in the intervention group (18 women; mean age of 70.39 ± 9.02 years) were analyzed. At the end of the treatment, the difference between groups for the total WOMAC score was -10.4 points (p = 0.00), 4.7 points (p = 0.00) for the Berg Balance Scale, and 45.2 mt (p = 0.00) for the six-minute walk test All differences were in favor of the intervention group.

CONCLUSIONS

In the short term, the addition of virtual reality via the Nintendo Wii and its Wii Balance Board platform showed statistically significant differences in the function of patients with total hip replacement, but these differences were not minimally clinically important.Trial registration: This research was registered in the Clinical Trials Registry of Australia and New Zealand, with reference ACTRN12618001252202.

Rest Intervals during Virtual Reality Gaming Augments Standing Postural Sway Disturbance

Immersive virtual reality (VR) can cause acute sickness, visual disturbance, and balance impairment. Some manufacturers recommend intermittent breaks to overcome these issues; however, limited evidence examining whether this is beneficial exists. The aim of this study was to examine whether taking breaks during VR gaming reduced its effect on postural sway during standing balance assessments. Twenty-five people participated in this crossover design study, performing 50 min of VR gaming either continuously or with intermittent 10 min exposure/rest intervals. Standing eyes open, two-legged balance assessments were performed immediately pre-, immediately post- and 40 min post-exposure. The primary outcome measure was total path length; secondary measures included independent axis path velocity, amplitude, standard deviation, discrete and continuous wavelet transform-derived variables, and detrended fluctuation analysis. Total path length was significantly (p < 0.05) reduced immediately post-VR gaming exposure in the intermittent rest break group both in comparison to within-condition baseline values and between-condition timepoint results. Conversely, it remained consistent across timepoints in the continuous exposure group. These changes consisted of a more clustered movement speed pattern about a lower central frequency, evidenced by signal frequency content. These findings indicate that caution is required before recommending rest breaks during VR exposure until we know more about how balance and falls risk are affected.

Instrumented platforms for balance and proprioceptive assessment in patients with total knee replacement: A systematic review and meta-analysis

BACKGROUND

The functional outcome of total knee replacement (TKR) is usually satisfying. However, patients may show functional limitations for years after surgery, which have been ascribed to impairments in balance and proprioception, mainly during standing tasks. A number of instrumentations and parameters have been used, rising confusion for clinical decisions on the assessment of patients.

RESEARCH QUESTION

Which are the most widespread and consistent procedures to assess balance and proprioception following TKR?

METHODS

A literature review was conducted in Pubmed, PEDro, and Cochrane database. From a total sample of 112 articles, 23 original studies published between 2008 and 2019 met inclusion criteria. The primary outcomes selected were variables related to balance and proprioception assessment in static and dynamic tasks performed with instrumented platforms. Data from papers using the same instrumentation, on patients with unilateral TKA and at least 12 months postoperatively were synthesized quantitatively in a random effect meta-analysis.

RESULTS

Fourteen articles were appropriate for the review. A large variability was found both in the instrumentation and the parameters used. The Neurocom Balance Master System™ was the most used instrument (four articles). On a total population of 186 patients with unilateral TKR 12 months postoperatively, a low degree of heterogeneity was found adopting the random effect in the four tasks explored (Firm and Foam Surface both with Eyes Open and Eyes Closed).

SIGNIFICANCE

This review found a large variability in the instrumentation used to assess balance and proprioception in patients operated on TKR. The meta-analysis demonstrated that the Neurocom Balance Master System™ for static assessment of balance showed an acceptable consistency and can be considered as a reference for further studies. However, balance and proprioception impairments following TKR have not been widely quantified by means of instrumented platforms. Further research is needed to address this issue, and improve clinical practice.

Postural Stability and Dynamic Balance in Adult Spinal Deformity: Prospective Pilot Study

OBJECTIVE

We sought to evaluate dynamic balance and postural stability in patients with adult spinal deformity (ASD) compared with published age-matched normative data.

METHODS

Eleven patients with ASD were prospectively enrolled. Postural stability was tested using static and dynamic posturography; patients stood on a movable platform with an integrated force plate and performed standardized sensory organization testing (SOT), evaluating the influence of sensory processing on postural stability under 6 conditions, and motor control testing, assessing reflexive postural reactions to an external perturbation. Patient performance was compared with that of published age-matched controls. Quality of life metrics included scores on the Scoliosis Research Society-22 questionnaire, SF-36, and Morse Fall Scale. Correlations between postural stability and radiographic measurements were performed.

RESULTS

ASD patients demonstrated significantly lower SOT scores (P ≤ 0.03) in 5 of 6 conditions tested and greater latency of limb movement during backward translation (P = 0.04) compared with controls. Lower SOT scores were associated with a history of falls. ASD patients who self-reported falling in the previous 6 months, when compared with nonfallers, demonstrated significantly lower SOT scores (P = 0.04) and significantly lower Scoliosis Research Society-22 self-image subscores (P = 0.003). Thoracic kyphosis and mediolateral sway (predictor of falls) were positively correlated in the eyes-open and eyes-closed conditions (P ≤ 0.04).

CONCLUSIONS

ASD patients demonstrated impaired postural stability, diminished sensory integration, and delayed response to external perturbations compared with normal control data. Postural stability and quality of life metrics correlated with self-reported falls. These findings suggest that ASD patients have abnormal postural stability and may be at elevated risk of falls.

Comparing single and multi-joint methods to detect knee joint proprioception deficits post primary unilateral total knee arthroplasty

BACKGROUND

The use of various single-joint proprioception measurements has resulted in contradictory findings after knee arthroplasty. The use of balance as a surrogate measure to assess knee proprioception post-operation has resulted in further confusion. The aim of this study was to measure single joint knee proprioception in participants after unilateral knee arthroplasty, and compares it to multi-joint balance.

METHODS

Eleven participants at 1 year after unilateral total knee arthroplasty and twelve age-matched controls were enrolled. The threshold to detect passive motion and the sensory organization test were used to measure single joint knee proprioception and multi-joint balance respectively. Two-way ANOVA and independent t-tests were used to measure differences between and within groups. Regression analysis was used to measure the association between proprioception and balance measurements.

FINDINGS

Surgical knees demonstrated significantly more deficient proprioception compared to the non-surgical knees and both knees of the control groups during flexion (P < 0.01) and extension (P < 0.05). Non-surgical knees showed similar proprioception to both knees of the control group during flexion and extension. Within the knee arthroplasty group, only deficiencies during flexion showed significant correlation with Sensory Organization Test visual ratio. No additional differences between both groups during balance measurements, nor any correlations between local joint proprioception and balance were seen.

INTERPRETATION

These findings indicate deficient surgical knee proprioception in participants one year after unilateral total knee arthroplasty. Limited associations between measurements indicate that balance may be a poor measure of single-joint proprioception.

Preoperative high-intensity strength training improves postural control after TKA: randomized-controlled trial

PURPOSE

This study investigates the effectiveness of preoperative high-intensity strength training (with a special emphasis on lower limb muscle strength and secondarily on balance training) on postural control after TKA.

METHODS

Forty-four subjects (7 men, 37 women, and mean age 66.7 ± 3.9 years) scheduled for unilateral TKA for osteoarthritis (OA) participated in this randomized-controlled trial. Each patient performed two postural control tests: Romberg test with eyes open and closed. These tests were assessed at 8 weeks before surgery (T1), after 8 weeks of training (T2), 1 month after TKA (T3), and finally 3 months after TKA (T4). The intervention group completed an 8-week training program 3 days per week prior to surgery, while the control group received no intervention.

RESULTS

The Center of Pressure area (COP) was lower (i.e., better score) for the intervention group at T2, T3, and T4. The anteroposterior range of COP with eyes open was lower in the intervention group at T2, T3, and T4 and with eyes closed at T2. The medial-lateral standard deviation of COP with eyes open was lower in the intervention group at T2 and T4 and with eyes closed at T2 and T3. The anteroposterior standard deviation of COP with eyes open did not change, while that with eyes closed the intervention group showed lower score at T2.

CONCLUSION

Preoperative high-intensity strength training is effective for improving postural control before and early after TKA. Recommendations should include preoperative strength training, and not only balance training, to speed-up recovery of postural control after TKA.

LEVEL OF EVIDENCE

1.

Postural control and balance in a cohort of healthy people living in Europe: An observational study

In the past 20 years, posturography has been widely used in the medical field. This observational study aimed to report the values derived from posturography of a wide set of healthy subjects from various European countries using a plantar pressure platform and a standardized method of measurement.A random cluster sampling of 914 healthy subjects aged between 7.0 and 85.99 years, stratified by age, was carried out. To provide percentile values of our cohort, data were processed to obtain 3 curves corresponding to the following percentiles: 25th, 50th, 75th, and the interquartile range. Distance-weighted least squares method was used to represent the percentile on appropriate graphs.In our sample, the balance to improve with age, up to approximately 45 years, but the trend to reverse with older age. The data show that the oscillations on the sagittal plane (y-mean) change with advancing age. Young people had more retro-podalic support than older people; the balance shifted forward in elderly people.As the study included a relatively large quantity of data collected using a standardized protocol, these results could be used as normative values of posturography for similar populations. On the basis of this data, correct diagnostic clues will be available to clinicians and professionals in the field. However, further studies are needed to confirm our findings.

Postural Control in Lowlanders With COPD Traveling to 3100 m: Data From a Randomized Trial Evaluating the Effect of Preventive Dexamethasone Treatment

Objective: To evaluate the effects of acute exposure to high altitude and preventive dexamethasone treatment on postural control in patients with chronic obstructive pulmonary disease (COPD).

Methods: In this randomized, double-blind parallel-group trial, 104 lowlanders with COPD GOLD 1-2 age 20–75 years, living near Bishkek (760 m), were randomized to receive either dexamethasone (2 × 4 mg/day p.o.) or placebo on the day before ascent and during a 2-day sojourn at Tuja-Ashu high altitude clinic (3100 m), Kyrgyzstan. Postural control was assessed with a Wii Balance Board^TM at 760 m and 1 day after arrival at 3100 m. Patients were instructed to stand immobile on both legs with eyes open during five tests of 30 s each, while the center of pressure path length (PL) was measured.

Results: With ascent from 760 to 3100 m the PL increased in the placebo group from median (quartiles) 29.2 (25.8; 38.2) to 31.5 (27.3; 39.3) cm (P < 0.05); in the dexamethasone group the corresponding increase from 28.8 (22.8; 34.5) to 29.9 (25.2; 37.0) cm was not significant (P = 0.10). The mean difference (95% CI) between dexamethasone and placebo groups in altitude-induced changes (treatment effect) was -0.3 (-3.2 to 2.5) cm, (P = 0.41). Multivariable regression analysis confirmed a significant increase in PL with higher altitude (coefficient 1.6, 95% CI 0.2 to 3.1, P = 0.031) but no effect of dexamethasone was shown (coefficient -0.2, 95% CI -0.4 to 3.6, P = 0.925), even when controlled for several potential confounders. PL changes were related more to antero-posterior than lateral sway. Twenty-two of 104 patients had an altitude-related increase in the antero-posterior sway velocity of >25%, what has been associated with an increased risk of falls in previous studies.

Conclusion: Lowlanders with COPD travelling from 760 to 3100 m revealed postural instability 24 h after arriving at high altitude, and this was not prevented by dexamethasone.

Trial Registration:clinicaltrials.gov Identifier: NCT02450968.

SeeSway - A free web-based system for analysing and exploring standing balance data

BACKGROUND AND OBJECTIVES

Computerised posturography can be used to assess standing balance, and can predict poor functional outcomes in many clinical populations. A key limitation is the disparate signal filtering and analysis techniques, with many methods requiring custom computer programs. This paper discusses the creation of a freely available web-based software program, SeeSway (www.rehabtools.org/seesway), which was designed to provide powerful tools for pre-processing, analysing and visualising standing balance data in an easy to use and platform independent website.

METHODS

SeeSway links an interactive web platform with file upload capability to software systems including LabVIEW, Matlab, Python and R to perform the data filtering, analysis and visualisation of standing balance data. Input data can consist of any signal that comprises an anterior-posterior and medial-lateral coordinate trace such as center of pressure or mass displacement. This allows it to be used with systems including criterion reference commercial force platforms and three dimensional motion analysis, smartphones, accelerometers and low-cost technology such as Nintendo Wii Balance Board and Microsoft Kinect. Filtering options include Butterworth, weighted and unweighted moving average, and discrete wavelet transforms. Analysis methods include standard techniques such as path length, amplitude, and root mean square in addition to less common but potentially promising methods such as sample entropy, detrended fluctuation analysis and multiresolution wavelet analysis. These data are visualised using scalograms, which chart the change in frequency content over time, scatterplots and standard line charts. This provides the user with a detailed understanding of their results, and how their different pre-processing and analysis method selections affect their findings.

RESULTS

An example of the data analysis techniques is provided in the paper, with graphical representation of how advanced analysis methods can better discriminate between someone with neurological impairment and a healthy control.

CONCLUSIONS

The goal of SeeSway is to provide a simple yet powerful educational and research tool to explore how standing balance is affected in aging and clinical populations.

Reliability and validity of the Wii Balance Board for assessment of standing balance: A systematic review

The use of force platform technologies to assess standing balance is common across a range of clinical areas. Numerous researchers have evaluated the low-cost Wii Balance Board (WBB) for its utility in assessing balance, with variable findings. This review aimed to systematically evaluate the reliability and concurrent validity of the WBB for assessment of static standing balance. Articles were retrieved from six databases (Medline, SCOPUS, EMBASE, CINAHL, Web of Science, Inspec) from 2007 to 2017. After independent screening by two reviewers, 25 articles were included. Two reviewers performed the data extraction and quality assessment. Test-retest reliability was investigated in 12 studies, with intraclass correlation coefficients or Pearson's correlation values showing a range from poor to excellent reliability (range: 0.27 to 0.99). Concurrent validity (i.e. comparison with another force platform) was examined in 21 studies, and was generally found to be excellent in studies examining the association between the same outcome measures collected on both devices. For studies reporting predominantly poor to moderate validity, potentially influential factors included the choice of 1) criterion reference (e.g. not a common force platform), 2) test duration (e.g. <30 s for double leg), 3) outcome measure (e.g. comparing a centre of pressure variable from the WBB with a summary score from the force platform), 4) data acquisition platform (studies using Apple iOS reported predominantly moderate validity), and 5) low sample size. In conclusion, evidence suggests that the WBB can be used as a reliable and valid tool for assessing standing balance. Protocol registration number: PROSPERO 2017: CRD42017058122.

An exploratory study examining factors underpinning postural instability in older adults with idiopathic neck pain

There is limited understanding of potential mechanisms underpinning postural control deficits in people with neck pain. This study examined several characteristics that might explain impaired postural stability in a group of older adults with neck pain, and compared the results in this cohort with that of asymptomatic controls. In this cross-sectional study we compared physical activity, lower limb motor and sensory function, vestibular and visual function, falls efficacy and dizziness handicap in 84 older adults with (n=35, age 69.6±6.3) and without (n=49, age 69.4±4.7) idiopathic neck-pain. Additionally, dynamic balance was assessed using the dynamic gait index (DGI) and standard and wavelet analysis of static balance was computed after data capture. Physical activity levels, lower limb motor and sensory function, vestibular function and visual contrast sensitivity were not different between groups (p>0.05). The neck-pain group demonstrated higher falls efficacy (p=0.01), greater levels of dizziness handicap (p<0.01), and higher CoP velocity measures in the moderate (1.56-6.25Hz) and low (0.39-1.56Hz) frequency bandwidths. Our results suggest that neck-pain induced postural control deficits in older adults may not be associated with the physical activity levels, lower limb motor and sensory function, or vestibular and visual function. Inferring from wavelet analysis results, we speculated that sensory re-weighting may have occurred to compensate for the deficits in neck proprioception. Further research is warranted to determine neck specific mechanisms underpinning postural control dysfunction in neck pain.