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Disease-related outcomes influence prevalence of falls in people with rheumatoid arthritis - 21/02/19

Doi : 10.1016/j.rehab.2018.09.003 
J. Zonzini Gaino a, M. Barros Bértolo a, C. Silva Nunes c, C. de Morais Barbosa b, Z. Sachetto a, M. Davitt c, E. de Paiva Magalhães c,
a Department of internal medicine, rheumatology, faculty of medical sciences, State University of Campinas-Unicamp, Campinas, São Paulo, Brazil 
b Department of internal medicine, gerontology, faculty of medical sciences, State University of Campinas-Unicamp, Campinas, São Paulo, Brazil 
c Orthoses and Prostheses Unit, Clinical Hospital, State University of Campinas-Unicamp, Campinas, São Paulo, Brazil 

Corresponding author. Unidade de Órteses e Próteses, Hospital de Clínicas da Unicamp, rua Vital Brazil 251, Cidade Universitária Zeferino Vaz, 13083-888 Campinas/SP, Brazil.Unidade de Órteses e Próteses, Hospital de Clínicas da Unicamprua Vital Brazil 251, Cidade Universitária Zeferino Vaz13083-888 Campinas/SPBrazil

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Highlights

The occurrence of falls is high in people with rheumatoid arthritis.
Falls are most associated with disease-related outcomes in rheumatoid arthritis.
Physical performance tests (BBS, TUG and SST5), HAQ-DI and mainly CDAI may be used to assess fall risk in clinical practice.

Le texte complet de cet article est disponible en PDF.

Abstract

Background

Patients with rheumatoid arthritis (RA) are at increased risk of falls, with potential adverse outcomes. There is a considerable variation across studies regarding the prevalence of falls and its correlation with clinical data, disease-related outcomes and physical performance tests.

Objective

The aim of this study was to evaluate the prevalence of falls and its association with clinical data, disease-related outcomes and physical performance tests.

Methods

In this cross-sectional study, 113 RA patients were divided into 3 groups — “non-fallers”, “sporadic fallers” and “recurrent fallers” — and compared in terms of clinical data, 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) and 5-Time Sit Down-To-Stand Up Test (SST5). Logistic regression analysis was performed to analyze the associations between the studied variables and the occurrence of falls, estimating odds ratios (ORs). We also analyzed the correlation between disease outcome measures (HAQ-DI and CDAI) and physical tests (BBS, TUG, SST5).

Results

Falls and fear of falling were reported by 59 (52.21%) and 71 (64.5%) patients, respectively. Significant associations were found between “recurrent fallers” and vertigo (OR=3.42; P=0.03), fear of falling (OR=3.44; P=0.01), low income (OR=2.02; P=0.04), CDAI (OR=1.08; P<0.01), HAQ-DI (OR=3.66; P<0.01), Lower-limb HAQ (OR=3.48; P<0.01), FFI-pain (OR=1.24; P=0.03), 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), TUG score (OR=1.13; P=0.03) and SST5 score (OR=1.06; P=0.02). On multivariate analysis, CDAI was the only significant predictor of recurrent falls (OR=1.08; P<0.01). Physical performance test scores (BBS, TUG, SST5) were correlated with the CDAI and HAQ-DI.

Conclusion

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

Le texte complet de cet article est disponible en PDF.

Keywords : Rheumatoid Arthritis, Falls, Disease activity, Disability, Physical performance tests


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Vol 62 - N° 2

P. 84-91 - mars 2019 Retour au numéro
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