INFLUENCE OF OPEN VS. CLOSED KINETIC CHAIN EXERCISES ON JOINT STABILITY AND PROPRIOCEPTION IN ELDERLY POPULATIONS

Abstract

Background: Ageing is associated with declines in muscle strength, neuromuscular control, balance, and proprioception, which may contribute to impaired joint stability and an increased risk of falls. Open kinetic chain (OKC) and closed kinetic chain (CKC) exercises are commonly used to improve lower-limb function; however, their comparative effects on proprioception and functional stability in older adults remain insufficiently established. Therefore, this study aimed to compare the effects of OKC and CKC exercises on joint stability and proprioception in older adults.

Methods: A parallel-group randomised controlled trial was conducted among community-dwelling older adults aged ≥60 years. Eighty participants were randomly allocated equally to an OKC group (n=40) or a CKC group (n=40). The OKC group performed seated knee extensions, seated hamstring curls, straight leg raises, and hip adduction/abduction exercises, whereas the CKC group performed wall squats, step-ups, forward lunges, and weight-bearing calf raises. Both groups participated in supervised exercise sessions three times per week for 8 weeks. Proprioception was assessed using active knee joint position sense (JPS) error at target angles of 30° and 60°, while balance and functional stability were assessed using the Berg Balance Scale (BBS). Assessments were conducted at baseline and after completion of the intervention. Paired-samples t-tests were used for within-group comparisons, whereas independent-samples t-tests were used to compare changes between groups.

Results: Seventy-five participants completed the study, including 37 in the OKC group and 38 in the CKC group. Both groups demonstrated statistically significant improvements in JPS and BBS scores following the intervention. In the OKC group, JPS error decreased by 0.9° at 30° (p=0.007) and 1.0° at 60° (p=0.005), while BBS scores improved by 2.9 points (p<0.001). In the CKC group, JPS error decreased by 2.6° at 30° and 2.8° at 60° (both p<0.001), while BBS scores improved by 7.8 points (p<0.001). Between-group analysis demonstrated significantly greater improvements in the CKC group for JPS error at 30° (mean difference=1.7°, p<0.001), JPS error at 60° (mean difference=1.8°, p<0.001), and BBS score (mean difference=4.9 points, p<0.001).

Conclusion: Both OKC and CKC exercise programmes significantly improved proprioceptive accuracy and functional stability in older adults. However, CKC exercises produced significantly greater improvements in knee joint position sense and balance compared with OKC exercises. CKC exercise may therefore represent a more effective approach for enhancing functional stability and proprioception in older adults.