Disease-related Outcomes Influence the Prevalence of Falls in People with Rheumatoid Arthritis

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Disease-related Outcomes Influence the Prevalence of Falls in People with Rheumatoid Arthritis
Key Take-Away: 

J. Zonzini Gaino et al. found out a high prevalence of falls in RA, mostly concerned with disease-related outcomes (primarily the Clinical Disease Activity Index (CDAI)). The results of Timed-up-and-go Test (TUG), Berg Balance Scale (BBS) and 5-Time Sit Down-To-Stand Up Test (SST5) were also related to recurrent falls, and these can be used as fall risk assessment tools in rheumatoid individuals.

Introduction:

Rheumatoid arthritis (RA) patients have increased risk of falls, with potential adverse outcomes. The studies vary considering the prevalence of falls and its correlation with clinical data, disease-related outcomes and physical performance tests. This study investigated the prevalence of falls and its relationship with clinical data, disease-related outcomes and physical performance tests.

 

Methods:

This cross-sectional study comprised of 113 RA patients who were divided into 3 groups - "non-fallers", "sporadic fallers" and "recurrent fallers". They were compared with respect to the clinical data, Clinical Disease Activity Index (CDAI), lower-limb tender and swollen joint count, disability HAQ-DI, Foot Function Index, Berg Balance Scale, Timed-up-and-go Test (TUG) and 5-Time Sit Down-To-Stand Up Test. Associations between the studied variables and the incidence of falls were analyzed using the Logistic regression analysis, estimating odds ratios (ORs). The investigators also found the correlation between disease outcome measures (HAQ-DI and CDAI) and physical tests (BBS, TUG, SST5).

 

Results:

Falls and fear of falling were described by 59 (52.21%) and 71 (64.5%) patients. Notable associations were found between "recurrent fallers" and vertigo (OR=3.42; P=0.03), low income (OR=2.02; P=0.04), fear of falling (OR=3.44; P=0.01), CDAI (OR=1.08; P<0.01), HAQ-DI (OR=3.66; P<0.01), FFI-pain (OR=1.24; P=0.03), Lower-limb HAQ (OR=3.48; P<0.01), FFI-total (OR=1.23; P=0.04), lower-limb tender joint count (OR=1.22; P<0.01), BBS score (OR=1.14; P<0.01), SST5 score (OR=1.06; P=0.02) and TUG score (OR=1.13; P=0.03). CDAI was the only important predictor of recurrent falls (OR=1.08; P<0.01) on multivariate analysis. Physical performance test scores (BBS, TUG, SST5) corresponded with CDAI and HAQ-DI.

 

Conclusion:

The prevalence of falls is high in RA, mostly influenced by disease-related outcomes. It is connected to worse performance on physical tests (BBS, TUG and SST5).

Source:

Annals of Physical and Rehabilitation Medicine

Link:

https://www.ncbi.nlm.nih.gov/pubmed/30278237

Original title of article:

Disease-related outcomes influence prevalence of falls in people with rheumatoid arthritis

Authors:

J.Zonzini Gaino et al.

Exploratory, Rheumatoid arthritis, Cross-sectional study, Clinical Disease Activity Index (CDAI), lower-limb tender and swollen joint count, disability (Health Assessment Questionnaire-Disability Index [HAQ-DI]), Foot Function Index (FFI), Berg Balance Scale (BBS), Timed-up-and-go Test (TUG), 5-Time Sit Down-To-Stand Up Test (SST5)
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