Romatoid Artritte Postüral Denge ve Düşme Riski

Year 2013, Volume: 38 Issue: 1, 72 - 77, 01.03.2013

Ahmet İnanır Sevil Okan Eren Yıldırım

Abstract

Amaç: Bu çalışmanın amacı Romatoid Artritin denge ve düşme riski üzerine olan etkilerini değerlendirmektir. Gereç ve yöntem: Çalışmaya toplam 70 olgu dahil edildi; bireylerin 35"i Romatoid artrit (11 erkek, 24 kadın), 35"i ise sağlıklı gönüllülerden (16 erkek, 19 kadın) oluşmakta idi. Hastalar ve sağlıklı gönüllüler denge ve düşme riski açısından Biodekx Denge Sistemi (BDS) ile değerlendirildi. Bulgular: Romatoid Artritli hastaların yaş ortalaması 46.47±9.47 yıl, kontrol grubunun ise 42.97±9.12 yıl idi. Gruplar yaş ve vücut kitle indeksi (VKİ) açısından değerlendirildiğinde istatistiksel olarak anlamlı fark saptanmadı (sırasıyla, p=0.129, p=0.207). Gruplar Genel Stabilite İndeksi (GSİ) ve Antero-Posterior Stabilite İndeksi(APSİ) açısından değerlendirildiğinde istatistiksel olarak anlamlı fark tespit edildi (sırasıyla, p

Keywords

Romatoid artrit, denge bozukluğu, düşme riski

Postural Stability and Fall Risk in Rheumatoid Arthritis

Abstract

Purpose: The aim of this study is to evaluate the effects of rheumatoid arthritis on postural balance and the risk of falls. Methods: A total of 70 sobjects were recruited for the study, including 35 with RA (11 men, 24 women) and 35 healthy controls (16 men, 19 women). Patients were evaluated with the Biodex Stability System in terms of balance and risk of falling. Results: The average age of patients with Rheumatoid Arthritis 46.47 ± 9.47 years, mean age of the control group was 42.97 ± 9.12 years. The mean age and body mass index of the participants did not significantly differ between groups (p=0.129, p=0.207, respectively). When groups were evaluated in terms of Overall Stability Index (OSI), Antero-Posterior Stability Index (APSI), evaluations showed that RA patients" test scores were statistically higher than control group (respectively, p

Keywords

Rheumatoid arthritis, Balance Disorder, Risk of Falling

References

• Harris ED. Clinical features of rheumatoid arthritis. In: Ruddy S, Harris ED, Sledge CB, editors. Kelley’s Textbook of Rheumatology. 6th edition, Elsevier, Philadelphia: WB Saunders Company. 2001; 9671000.
• Dreyer SJ, Boden SD. Natural history of rheumatoid arthritis of the cervical spine. Clin Orthop. 1999; 366:98-106.
• Yoshino S, Shiga H, Nakamura H, Nagashima M. Longterm outcome of total joint arthroplasty in nonambulatory patients with rheumatoid arthritis. J Rheumatol. 1999; 26:1076–9.
• Ekdahl C, Anderson SI, Svensson B. Muscle function of the lower extremities in rheumatoid arthritis and osteoarthrosis: a descriptive study of patients in a primaryhealth care district. J Clin Epidemiol. 1989; 42: 947-54.
• Aydog E, Aydog ST, Cakci A, Doral MN. Dynamic postural stability in blind athletes using the biodex stability system. Int J Sports Med. 2006; 27:415-8.
• Tjon A, Hen SS, Geurts AH, Pad Bosch, PV, Laan RM, Mulder T. Postural control in rheumatoid arthritis patients scheduled for total knee arthroplasty. Arch Phys Med Rehab. 2000; 81:1489–93.
• Rome K , Dixon J, Gray M, Woodley R. Evaluation of static and dynamic postural stability in established rheumatoid arthritis: Exploratory study. Clin Biomechanics. 2009; 24: 524–26.
• Lawlor DA, Patel R, Ebrahim S. Association between falls in elderly women and chronic diseases and drug use: cross sectional study. BMJ. 2003; 327:712-7.
• Fessel KD, Nevitt MC. Correlates of fear of falling and activity limitation among persons with rheumatoid arthritis. Arthritis Care Res. 1997; 10: 222Luoto S, Riikonen K, Siivola M, Laiho K, Kauppi M, Mikkelsson M. Impaired postural control is associated with worse scores of the Health Assessment Questionnaire disability index among women with rheumatoid arthritis. J Rehabil Med. 2011; 43: 900-5.
• Briggs RC, Gossman MR, Birch R, Drews JE, Shaddeau SA. Balance performance among noninstitutionalized elderly women. Phys Ther. 1989; 69:748–56.
• Hinman RS, Bennell KL, Metcalf BR, Crossley KM. Balance impairments in individuals with symptomatic knee osteoarthritis: a comparison with matched controls using clinical tests. Rheumatology. 2002; 41:1388-94.
• Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in communitydwelling older adults using the timed up and go test. Phys Ther. 2000; 80:896–903.
• Baldwin SL, Van Arnam TW, Ploutz-Snyder LL. Reliability of dynamic bilateral postural stability on the Biodex Stability System in older adults, Med Sci Sport Exerc. 2004; 36:530.
• Aydog ST, Aydog EC， Akci A, Doral MN. Reproducibility of postural stability score in blind athletes. Isokinetic Exerc Sci. 2004; 12:229–32.
• Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 1988; 31:315–24.
• Cachupe JCW, Shifflet B, Kahanov L, Wughalter EH. Reliability of biodex balance system measures. Meas Phys Edu Exerc Sci. 2001; 5:97-108
• Aydog, E., Bal, A., Aydog, S.T., Cakci, A. Evaluation of dynamic postural balance using the biodex stability system in rheumatoid arthritis patients. Clin. Rheumatol. 2006; 25: 462–7.
• Woolf AP. Burden of major musculoskeletal conditions. Bull World Health Organ. 2003; 81:646
• Ekdahl C, Andersson SI. Standing balance in rheumatoid arthritis: a comparative study with healthy subjects. Scand J Rheumatol. 1989; 18:33-42.
• Woodburn J, Helliwell PS, Barker S. Threedimensional kinematics at the ankle joint complex in rheumatoid arthritis patients with painful valgus deformity of the rearfot. Rheumatology. 2002; 41:1406–12
• Platto MJ, O’Connell PG, Hicks JE, Gerber LH. The relationship of pain and deformity of the rheumatoid foot to gait and an index of functional ambulation. J Rheumatol. 1991; 18:38–43.
• Mengshoel AM, Clarke-Jenssen AC, Fredriksen B, Paulsen T. ‘Clinical examination of balance and stability in rheumatoid arthritis patients’, Physiotherapy. 2000; 86: 342-347.
• Ekdahl C.Postural control, muscle function and psychological factors in rheumatoid arthritis. Are there any relations? Scand J Rheumatol. 1992; 21: 297-301
• Wilson O, Kirwan JR. Measuring sensation in the feet of patients with rheumatoid arthritis. Musculoskelet Care. 2006; 4:12–23.
• Marcora SM, Lemmey AM, Maddison PJ. Can progressive resistance training reverse cachexia in patients with rheumatoid arthritis? Result of a pilot study. J Rheumatol. 2005; 32:1031-9.
• Suomi R, Kojeca DM. Postural sway characteristics of women with lower extremity arthritis before and after an aquatic exercise intervention. Arch Phys Med Rehabil. 2000; 81:780–85.
• Williams HG, McClenaghan BA, Dickerson J. Spectral characteristics of postural control in elderly individuals. Arch Phys Med Rehabil. 1997; 78:737– 7
• Jamison M, Neuberger GB, Miller PA. Correlates of falls and fear of falling among adults with rheumatoid arthritis. Arthritis Rheum. 2003; 49:673–80.
• Armstrong C, Swarbrick CM, Pye SR, O'Neill TW. Occurrence and risk factors for falls in rheumatoid arthritis. Ann Rheum Dis. 2005; 64:1602–4.
• Hayashibara M, Hagino H, Katagiri H, Okano T, Okada J, Teshima RIncidence and risk factors of falling in ambulatory patients with rheumatoid arthritis: a prospective 1-year study. Osteoporos Int. 2010; 21:1825-33.
• Yazışma Adresi / Address for Correspondence: Dr. Ahmet İnanır Gaziosma npaşa Üniversitesi Tıp Fakültesi Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı 60100 TOKAT Tel: [phone] e-mail: [e-mail] geliş tarihi/received :19.08.2012 kabul tarihi/accepted:01.10.2012