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THU0167 Falls in rheumatoid arthritis (RA) and its relation to disease activity, disability and physical performance tests
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  1. J.Z. Gaino1,
  2. M.B. Bertolo2,
  3. C.S. Nunes1,
  4. C.M. Barbosa1,
  5. Z. Sachetto2,
  6. M. Davitt1,
  7. E.D.P. Magalhães2
  1. 1UNICAMP, Campinas, Brazil
  2. 2Rheumatology, UNICAMP, Campinas, Brazil

Abstract

Background Rheumatoid patients(RA)are known to have an increased falls incidence with a threefold increased risk of hip fracture. Few studies have been conducted to evaluate the relation between falls, disease activity, disability and physical functioning.

Objectives To evaluate the prevalence of falls in RA and its relation with disease activity, disability and physical performance tests.

Methods 113 RA patients were evaluated from the outpatient clinic of the Rheumatology Division of the State University of Campinas/Unicamp. Patients were assessed for occurrence of falls in last year, fear of falling, sociodemographic and clinical data (medication, visual impairment, vertigo, physical activity, body mass index, disease duration, rheumatoid factor, lower limb swollen and tender joints, foot tactile sensitivity, disease activity-CDAI and disability-HAQ). Subjects were submitted to Berg Balance Scale-BBS, the Timed Up and Go Test-TUG and 5-Time Sit Down-to-Stand Up Test-SST5 and were divided in “Fallers” and “Non-Fallers” groups. For comparison of groups the chi-squared test, Fisher’s exact test and Mann-Whitney were used. Univariate linear regression and multivariate analysis were used to analyse the relation between sociodemographic, clinical data and physical tests with the occurrence of falls. Kruskal- Wallis test was used for analysis of the association of BBS, TUG and SST5 with CDAI and HAQ. The data were analysed with a 5% level of significance.

Results 52.21% reported the occurrence of falls in the past 12 months and 62.8%were fearful of falling. Comparing “Fallers” and “Non-Fallers”, significant differences were noted for HAQ(p=0.0242), fear of falling(p=0.0196) and BBS(p=0.0120). After univariate logistic regression there was association of falls with income(OR 1.05), HAQ(OR 1.945), fear of falling(OR 2.586) and TUG (OR 1.09). In multivariate model, income was independently linked to falls(OR 1.07). BBS, TUG, SST5 were correlated with CDAI and HAQ(p<0.05).

Conclusions RA patients have high prevalence of falls and fear of falling. Income was an independent fall risk factor. BBS seems to be higher among fallers and TUG can be considered a fall risk predictor. BBS, TUG and SST5 are related to CDAI and HAQ. CDAI does not seems to be a good instrument to predict falls due to its variability over time. In clinical practice, HAQ can be a valuable tool to recognise patients with an increased risk of falls.

References [1] Stanmore EK, Oldham J, Skelton DA, et al. Risk factors for falls in adults with rheumatoid arthritis: a prospective study. Arthritis Care Res2013Aug;65(8):1251–8.

[2] Brenton-Rule A, Dalbeth N, Menz HB, et al. The incidence and risk factors for falls in adults with rheumatoid arthritis: a systematic review. Semin Arthritis Rheum2014;44:389–98.

[3] Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J AmGeriatr Soc1991; 39:142–8.16.

[4] Berg KO, Maki BE, Williams JI, et al. Clinical and laboratory measures of postural balance in an elderly population. Arch Phys Med Rehabil1992;73:1073–1080.

[5] Bohannon RW. Test-retest reliability of the five-repetition sit-to-stand test: a systematic review of the literature involving adults. J Strength Cond Res2011; 25:3205–7.

Disclosure of Interest None declared

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