Background Rheumatoid arthritis (RA) patients1 and postmenopausal women2 showed an increased fall risk. Research pointed to some gait biomechanical parameters related with falls (GBPRF)3 and found differences in these parameters between elderly and young: elderly showed higher ratio of head to hip horizontal acceleration and higher heel horizontal velocity at heel contact with the ground3; elderly and young showed similar minimum toe clearance values however elders had greater variability.4 There is strong evidence that balance and coordination exercises (proprioceptive exercises, PE) can reduce fall rates in elderly.5
Objectives Analyze the PE effects in RA postmenopausal women relatively to disease activity, functional capacity and GBPRF.
Methods RA postmenopausal women (n=7) participated in a 12-week PE individual program (3 sessions/week, 30 minutes/session). Data collected pre and post-program. DAS28 and HAQ used to evaluate disease activity and functional capacity. Vicon® Motion Capture system recorded kinematics data (9 MX1.3 cameras, 200Hz) synchronized with a force plate (AMTI BP400600-200, 1000Hz). Data analyzed by Vicon® Nexus software (1.7.1) based on an integrated model of 41 reflective markers relocation and subject anthropometric data, developing mechanical segments and joints centers. Subjects performed 14 valid trials (7 left and 7 right foot contacts with AMTI).
Results Improvements in HAQ (1.00 to 0.46, t student, p=0.005) and visual analogue scale for pain (4.95 to 2.07 cm, t student, p=0.003). DAS28 results remained statistical unchanged (4.32 to 3.54, t student, p=0.127). GBPRF did not show statistical differences (t student, p<0.05): left and right heel antero-posterior velocity (0.35 to 0.30 m/s, p=0.310; 0.30 to 0.28, p=0.604; respectively); left and right minimum toe clearance (2.07 to 1.86 cm, p=0.113; 1.94 to 1.87 cm, p=0.468); head antero-posterior velocity/hip antero-posterior velocity at 4 crucial gait instants (left heel contact - 0.85 to 0.87, p=0.440; right heel contact - 0.87 to 0.88, p=0.369; left minimum toe clearance - 1.08 to 1.06, p=0.168; right minimum toe clearance - 1.10 to 1.05, p=0.309; left contralateral heel contact - 0.88 to 0.87, p=0.367; right contralateral heel contact - 0.86 to 0.86, p=0.829; left toe off - 1.03 to 1.03, p=0.862; right toe off - 1.00 to 1.02, p=0.588).
Conclusions Despite the small number of participants data indicate that PE can improve functional capacity and reduce pain perception in RA postmenopausal women. In addition did not exacerbate disease activity. GBPRF did not show pre and post-program differences however a larger sample may allow observation of differences accompanying observed improvements in functional capacity.
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Disclosure of Interest None declared
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