Background Many patients with rheumatoid arthritis blame decreased balance as a reason for limiting their physical activity (1,2). It is therefore important to improve balance and reducing the risk of falling.
Objectives This study has evaluated the history of falling, the fear of falling and the fall risk in patients with rheumatoid arthritis and has investigated the relationship of these with functional status, balance, disability, walking speed and disease activity.
Methods 65 patients with RA and 43 healthy volunteers were included in the study. Their fall history within last year was questioned and any use of an assistive device was recorded. Steinbrocker functional class system has been used to identify the patients. The fear of falling was assessed using the Tinetti Falls Efficacy Scale (FES). Tinetti balance and gait tests, berg balance scale were performed for the evaluation of balance, gait and fall risk. The disability in both groups was evaluated in the Health Assessment Questionnaire (HAQ). The disease activity was evaluated with DAS28. 10 meter walk test, timed up and go test, one leg stand test, functional reach test were performed in both groups. Arthritis impact measurement scales 2-short form and 12-item short form health survey (SF-12) were performed in both groups.
Results 28 subjects in the patient group reported one or more falls within the year. When compared with subjects who did not report any falls, the subjects who reported ≥1 fall were older, had longer RA disease duration, higher HAQ scores, higher functional class and more fear of falling. According to the Tinetti Total score; 28 (%43,1) patients had low, 22 (%33,8) patients had medium, 15 (%23,1) patients had high fall risk. 1 unit increment in the functional class increased the risk of falling 9.89 times and 10 unit decrease in Tinetti FES score increased the risk of falling 1.94 times.
Conclusions The most important factors related to the fall risk were steinbrocker functional class and Tinetti FES score. Impaired body balance due to joint disorders was associated with the increased risk of falls in RA patients. The control of disease activity as early as possible is essential to reducing the risk of falls (3). The development of successful postural control rehabilitation methods for patients with RA might lead to the improvements in functional status and the decreased risk of falls.
Aydog,E., Bal,A., Aydog,S.T., Çakci,A., 2006 Evaluation of dynamic postural balance using the biodex stability system in rheumatoid arthritis patients.Clin.Rheumatol.25,462-467
Tjon,A., Hen,S.S., Gurts,A.H., Pad Bosch, P.V., Laan,R.M., Mulder,T., 2000.Postural control in rheumatoid arthritis patients scheduled for total knee arthroplasty Arch.Phys.Med.Rehab.81,1489-1493
M.Hayashibara, H.Hagino, H.Katagiri, T.Okano Incidence and risk factors of falling in ambulatory patients with rheumatoid arthritis: A prospective 1-year study International Osteoporosis Foundation and National Osteoporosis Foundation 2010
Disclosure of Interest None declared
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