Clinical and biomechanical factors associated with falls and rheumatoid arthritis: baseline cohort with longitudinal nested case-control study.
Accidental Falls
/ statistics & numerical data
Aged
Arthritis, Rheumatoid
/ complications
Biomechanical Phenomena
Case-Control Studies
Female
Gait
Humans
Longitudinal Studies
Male
Middle Aged
Muscle Strength
Patient Acuity
Prospective Studies
Quality of Life
Range of Motion, Articular
Regression Analysis
Risk Factors
Surveys and Questionnaires
RA
falls
gait analysis
muscle strength
postural control
Journal
Rheumatology (Oxford, England)
ISSN: 1462-0332
Titre abrégé: Rheumatology (Oxford)
Pays: England
ID NLM: 100883501
Informations de publication
Date de publication:
02 02 2022
02 02 2022
Historique:
received:
17
03
2021
revised:
22
04
2021
pubmed:
28
4
2021
medline:
11
3
2022
entrez:
27
4
2021
Statut:
ppublish
Résumé
To identify the clinical and biomechanical characteristics associated with falls in people with RA. A total of 436 people ≥60 years of age with RA completed a 1 year prospective survey of falls in the UK. At baseline, questionnaires recorded data including personal and medical history, pain and fatigue scores, health-related quality of life (HRQoL), physical activity and medication history. The occurrence of falls wasmonitored prospectively over 12 months by monthly self-reporting. A nested sample of 30 fallers (defined as the report of one or more falls in 12 months) and 30 non-fallers was evaluated to assess joint range of motion (ROM), muscle strength and gait parameters. Multivariate regression analyses were undertaken to determine variables associated with falling. Compared with non-fallers (n = 236), fallers (n = 200) were older (P = 0.05), less likely to be married (P = 0.03), had higher pain scores (P < 0.01), experienced more frequent dizziness (P < 0.01), were frequently taking psychotropic medications (P = 0.02) and reported lower HRQoL (P = 0.02). Among those who underwent gait laboratory assessments, compared with non-fallers, fallers showed a greater anteroposterior (AP; P = 0.03) and medial-lateral (ML) sway range (P = 0.02) and reduced isokinetic peak torque and isometric strength at 60° knee flexion (P = 0.03). Fallers also showed shorter stride length (P = 0.04), shorter double support time (P = 0.04) and reduced percentage time in swing phase (P = 0.02) and in knee range of motion through the gait cycle (P < 0.01). People with RA have distinct clinical and biomechanical characteristics that place them at increased risk of falling. Assessment for these factors may be important to offer more targeted rehabilitation interventions.
Identifiants
pubmed: 33905483
pii: 6255773
doi: 10.1093/rheumatology/keab388
pmc: PMC8824410
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
679-687Subventions
Organisme : Versus Arthritis
ID : 21229
Pays : United Kingdom
Organisme : Department of Health
ID : PB-PG-0808-14201
Pays : United Kingdom
Commentaires et corrections
Type : ErratumIn
Informations de copyright
© The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Rheumatology.
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