Background The feet are a common region of pathology in rheumatoid arthritis (RA). The outcome of foot pathology is often poor physical functioning due to both structural and functional impairments . Many people with RA suffer from reduced participation in activities of daily living and disability . Additional outcomes that can be caused by the impairments and reduced physical functioning resultant in RA consist of an increased risk of falling and fear of falling which can further effect quality of life, activity participation and disability . Worldwide, falls constitute a significant burden to healthcare resources in both older adults and the RA population . The consequences of falls include death, injury and loss of confidence. In addition, fear of falling and self-imposed activity limitation can result from falls in RA, which can detrimentally effect a person's quality of life. Currently, research is lacking in the area of the fear of falling and correlates with foot pain, impairment and disability in people with RA.
Objectives To evaluate the differences in fear of falling and foot pain, impairment and disability between women with established RA and age-matched controls, and to assess the relationship between fear of falling and foot pain, impairment and disability in women with established RA.
Methods Twenty-one women with RA with a mean (SD) age of 66 (10) years, and a mean (SD) disease duration of 18 (13) years were compared with 21 asymptomatic women mean (SD) age of 66 (10) years. Gait velocity was assessed as a measure of functional impairment. All participants completed the Falls Efficacy Scale-International (FES-1), which is used to measure participants' level of concern in regards to falling during physical and social activities. The Leeds Foot Impact Scale evaluated foot impairment (LFISIF) and disability (LFISAP). Foot pain was measured using a 100mm Visual Analogue Scale. Independent t-tests with a Bonferroni correction were used to examine the significant differences in fear of falling and foot pain, impairment and disability between cases and controls. Pearson's correlations were used to examine the significant relationships between fear of falling and foot pain, impairment and disability in the cases.
Results The results demonstrated a significant difference in fear of falling (p=0.001), foot impairment (p=0.004) and foot disability (p<0.001) between cases and controls. No significant difference was found in foot pain between cases and controls (p=0.052). The results demonstrated a significant correlation between fear of falling and foot impairment (r =0.53, p=0.02) and foot disability (r =0.77, p<0.001). No significant correlation was found between fear of falling and foot pain (r =0.36, p=0.11).
Conclusions Significant differences were observed between people with RA and age-matched controls with the fear of falling and foot impairment and disability. We found foot impairment and disability to be related to the fear of falling in women with established RA. Knowledge of risk factors related to the fear of falling in people with RA may be useful in developing multidimensional strategies to decrease fear of falling and improve quality of life.
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Disclosure of Interest None declared
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