Background Systemic Lupus Erythematosus (SLE) is a multisystem disease that has a broad range of manifestations. Balance as a complex task may be affected in SLE and this may cause postural instability and fall risk.
Objectives The aim of this study was to determine the fall risk in cases with SLE with an objective computerized technique and to evaluate the potential related risk factors for falls in these cases.
Methods Female patients with SLE (1997 ACR revised classification criteria for SLE) and female healty controls were included. Patients who were not able to tolerate posturography, with a history of orthopedic surgery and with known balance problems were excluded. The age, disease duration, anamnesis of falls, fear of falling and drugs used were recorded. Disease activity (with SLE disease activity index SELENA modification) and damage (with Systemic Lupus International Collaborating Clinics/ACR Damage Index) were evaluated. For the evaluation of fall efficacy, we used the Falls Efficacy Scale International (FES-I). Fall risk analysis was performed by Tetrax Interactive Balance System which is a computerized posturography device. By this method, fall risk is obtained as a numeric value (0–100) and as ranges indicating low, moderate or high risk of fall. We investigated age, disease duration, fall anamnesis, fear of falling, drug usage, FES-I, disease activity and damage as possibe related factors to fall risk. Mann–Whitney U, chi square and Spearman correlation tests were used for statistical analysis.
Results 48 cases with SLE and 30 controls were included. The mean ages of the cases and controls were 37,8±12,6 and 39,1±15,7 years, respectively. Symptom duration of the cases was 6,1±4,2 months. 7 cases (15%) had anamnesis of falls during the last 12 months, whereas only 1 control (3%) had this anamnesis (p<0,05). Fear of falling was reported by 40% of the cases and 30% of the controls (p<0,05). FES-I scores were found to be significantly higher in cases than controls (22±11 and 16±9 respectively; p=0,040). With the computerized system used, significantly higher fall risk results were recorded in patients with SLE than the controls (59,3±29,5 and 35,8±26,9, respectively; p<0,001). Low, moderate and high fall risks were recorded as 31%, 15% and 54% of the cases and 53%, 23% and 23% of the controls and this distribution was also significantly worse in cases than controls (p<0,05). No significant correlation was found between fall risk and other factors including age, disease duration, fall anamnesis, fear of falling, drug usage, disease activity and disease damage except FES-I which was significantly correlated both with fall risk assessment and fall risk category in cases (p<0,05).
Conclusions With an objective computerized technique, fall risk was found to be higher in cases with SLE than controls in our study. The higher fall risk in these patients seems to be affected by the disease itself, rather than its other characteristics. An increased awareness of the potential fall risk and future studies investigating the possible coexisting balance problems in SLE may contribute to the management.
Disclosure of Interest None declared