Association of fear of falling with balance, posture, and functionality in patients with ankylosing spondylitis: Comparison with healthy controls

Yıl 2024, Cilt: 41 Sayı: 2, 271 - 277, 19.05.2024

Hakan Bülbül , Yasemin Ulus , Ayhan Bilgici

Öz

The aim of the study was to compare the fear of falling in patients with ankylosing spondylitis (AS) and healthy controls. The relationship between the fear of falling and spinal mobility, balance parameters, functional capacity, pain, and disease activity was also evaluated in patients. The study sample included 40 AS patients and 50 gender-age-matched healthy controls. Falls Efficacy Scale-International (FES-I), Berg Balance-Scale (BBS), and Short-Physical Performance Battery (SPPB) were evaluated in all participants. In patients, the Bath AS-Metrology Index (BASMI), pain-visual analog scale (VAS), Bath AS-Disease Activity Index (BASDAI), and Bath AS-Functional Index (BASFI) were assessed. The mean ages of the patients and controls were 45.73 ± 9.5 (18-63) and 42.28 ± 8.1 (26-56), respectively. Fear of falling scores were significantly higher, and BBS and SPPB scores were significantly lower in patients than in controls (p<0.001). There was a positive correlation between FES-I scores and VAS-pain, BASFI, and BASDAI-scores, and a negative correlation was found between FES-I scores and BBS and SPPB-scores (SPPB p<0.05, others p<0.001). BASMI scores were negatively correlated with BBS scores (p<0.05). In the regression analysis, positive correlation with FES-I was BASFI-scores (p<0.05). The results of this study showed that patients with AS may experience fear of falling even if there is no history of falls. Balance, disease activity, and, most importantly, functional capacity should be evaluated to reduce the fear of falling in these patients.

Anahtar Kelimeler

Ankylosing spondylitis, balance, fear of falling, functionality, mobility

Etik Beyan

The Medical Research Ethics Committee (B.30.2.ODM.0.20.08/219) approved the study protocol and written informed consent was obtained from the participants.

Destekleyen Kurum

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Proje Numarası

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Teşekkür

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Kaynakça

• Van Der Linden S, Van Der Heijde D, Landewe R. Classification and epidemiology of spondyloarthritis. In: Hochberg M, Silman A, Smolen J, Weinblat M, Weisman M, editors. Rheumatology. 4th ed. Spain: Elsevier Limited; 2008. p. 1103-7.
• Reveille J. Clinical features of ankylosing spondylitis. In: Hochberg M, Silman A, Smolen J, Weinblat M, Weisman M, editors. Rheumatology 4th ed. Spain: Elsevier Limited; 2008. p. 1109-14.
• Vergara ME, O'Shea FD, Inman RD, Gage WH. Postural control is altered in patients with ankylosing spondylitis. Clin Biomech (Bristol, Avon). 2012;27(4):334-40.
• Murray HC, Elliott C, Barton SE, Murray A. Do patients with ankylosing spondylitis have poorer balance than normal subjects? Rheumatology (Oxford). 2000;39(5):497-500.
• Lim GRS, Ng CH, Kwan YH, Fong W. Prevalence and risk factors for falls in patients with spondyloarthritis: A systematic review. Int J Rheum Dis. 2021;24(5):623-32.
• Alkan H, Yıldız N, Sarsan A, Simsir A, Sevinc O, Topuz O, et al. Fall Risk in Patients with Ankylosing Spondylitis. Turk J Rheumatol. 2013;28(2):109-16.
• Fatemi G, Gensler LS, Learch TJ, Weisman MH. Spine fractures in ankylosing spondylitis: a case report and review of imaging as well as predisposing factors to falls and fractures. Semin Arthritis Rheum. 2014;44(1):20-4.
• Tinetti ME, Richman D, Powell L. Falls efficacy as a measure of fear of falling. J Gerontol. 1990;45(6):P239-43..
• Chu CL, Liang CK, Chow PC, Lin YT, Tang KY, Chou MY, et al. Fear of falling (FF): Psychosocial and physical factors among institutionalized older Chinese men in Taiwan. Arch Gerontol Geriatr. 2011;53(2):e232-6.
• Kendrick D, Kumar A, Carpenter H, Zijlstra GA, Skelton DA, Cook JR, et al. Exercise for reducing fear of falling in older people living in the community. Cochrane Database Syst Rev. 2014;2014(11):CD009848.
• Akyol Y, Ulus Y, Tander B, Tomak L, Zahiroglu Y, Bilgici A, et al. Falls, fear of falling, and associated factors in ambulatory patients with rheumatoid arthritis: A comparative study with healthy controls. Turk J Phys Med Rehabil. 2018;64(3):213-21.
• Oliveira CC, Lee A, Granger CL, Miller KJ, Irving LB, Denehy L. Postural control and fear of falling assessment in people with chronic obstructive pulmonary disease: a systematic review of instruments, international classification of functioning, disability and health linkage, and measurement properties. Arch Phys Med Rehabil. 2013;94(9):1784-99 e7.
• Jamison M, Neuberger GB, Miller PA. Correlates of falls and fear of falling among adults with rheumatoid arthritis. Arthritis Rheum. 2003;49(5):673-80
• van der Linden S, Valkenburg HA, Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum. 1984;27(4):361-8.
• Akkoc Y, Karatepe AG, Akar S, Kirazli Y, Akkoc N. A Turkish version of the Bath Ankylosing Spondylitis Disease Activity Index: reliability and validity. Rheumatol Int. 2005;25(4):280-4.
• Yanik B, Gursel YK, Kutlay S, Ay S, Elhan AH. Adaptation of the Bath Ankylosing Spondylitis Functional Index to the Turkish population, its reliability and validity: functional assessment in AS. Clin Rheumatol. 2005;24(1):41-7.
• Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A. A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index. J Rheumatol. 1994;21(12):2286-91.
• Calin A, Garrett S, Whitelock H, Kennedy LG, O'Hea J, Mallorie P, et al. A new approach to defining functional ability in ankylosing spondylitis: the development of the Bath Ankylosing Spondylitis Functional Index. J Rheumatol. 1994;21(12):2281-5.
• Jenkinson TR, Mallorie PA, Whitelock HC, Kennedy LG, Garrett SL, Calin A. Defining spinal mobility in ankylosing spondylitis (AS). The Bath AS Metrology Index. J Rheumatol. 1994;21(9):1694-8.
• Ulus Y, Durmus D, Akyol Y, Terzi Y, Bilgici A, Kuru O. Reliability and validity of the Turkish version of the Falls Efficacy Scale International (FES-I) in community-dwelling older persons. Arch Gerontol Geriatr. 2012;54(3):429-33.
• Yardley L, Beyer N, Hauer K, Kempen G, Piot-Ziegler C, Todd C. Development and initial validation of the Falls Efficacy Scale-International (FES-I). Age Ageing. 2005;34(6):614-9.
• Shumway-Cook A, Baldwin M, Polissar NL, Gruber W. Predicting the probability for falls in community-dwelling older adults. Phys Ther. 1997;77(8):812-9.
• Downs S. The Berg Balance Scale. J Physiother. 2015;61(1):46.
• Sahin F, Yilmaz F, Ozmaden A, Kotevolu N, Sahin T, Kuran B. Reliability and validity of the Turkish version of the Berg Balance Scale. J Geriatr Phys Ther. 2008;31(1):32-7.
• Guralnik JM, Ferrucci L, Pieper CF, Leveille SG, Markides KS, Ostir GV, et al. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci. 2000;55(4):M221-31.
• Gunduz OH, Ozcan-Eksi EE, Giray E, Yagci I. What Impairs Balance in Ankylosing Spondylitis? Posture or Disease Activity? Arch Rheumatol. 2017;32(3):221-6.
• Dursun N, Sarkaya S, Ozdolap S, Dursun E, Zateri C, Altan L, et al. Risk of falls in patients with ankylosing spondylitis. J Clin Rheumatol. 2015;21(2):76-80.
• Kempen GI, Todd CJ, Van Haastregt JC, Zijlstra GA, Beyer N, Freiberger E, et al. Cross-cultural validation of the Falls Efficacy Scale International (FES-I) in older people: results from Germany, the Netherlands and the UK were satisfactory. Disabil Rehabil. 2007;29(2):155-62.
• Batur EB, Karatas GK. Do postural changes affect balance in patients with ankylosing spondylitis? J Rehabil Med. 2017;49(5):437-40.
• Cinar E, Akkoc Y, Karapolat H, Durusoy R, Keser G. Postural deformities: potential morbidities to cause balance problems in patients with ankylosing spondylitis? Eur J Rheumatol. 2016;3(1):5-9.
• De Nunzio AM, Iervolino S, Zincarelli C, Di Gioia L, Rengo G, Multari V, et al. Ankylosing spondylitis and posture control: the role of visual input. Biomed Res Int. 2015;2015:948674.
• Durmus B, Altay Z, Ersoy Y, Baysal O, Dogan E. Postural stability in patients with ankylosing spondylitis. Disabil Rehabil. 2010;32(14):1156-62.
• Mewes KB, Longo B, Campos APB, Simioni J, Skare TL. Balance and falls in axial Spondyloarthritis: a cross sectional study. Acta Reumatol Port. 2019;44(4):248-53.
• Adam M, Leblebici, B., Erkan, N.E., Bağış, S., Akman, M.N. Ankilozan Spondilit ve Postüral Denge. Rheumatism. 2008;23(3):87-90.
• Aydog E, Depedibi R, Bal A, Eksioglu E, Unlu E, Cakci A. Dynamic postural balance in ankylosing spondylitis patients. Rheumatology (Oxford). 2006;45(4):445-8.
• Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther. 2000;80(9):896-903.
• Ulus Y, Akyol, Y.,Tander, B., Durmus, D., Bilgici, A., Kuru, O. The relationship between fear of falling and balance in community-dwelling older people. Turkish Journal of Geriatrics. 2013;16(3):260-5.
• Hadjistavropoulos T, Delbaere K, Fitzgerald TD. Reconceptualizing the role of fear of falling and balance confidence in fall risk. J Aging Health. 2011;23(1):3-23.
• Dagfinrud H, Kjeken I, Mowinckel P, Hagen KB, Kvien TK. Impact of functional impairment in ankylosing spondylitis: impairment, activity limitation, and participation restrictions. J Rheumatol. 2005;32(3):516-23.
• Scheffer AC, Schuurmans MJ, van Dijk N, van der Hooft T, de Rooij SE. Fear of falling: measurement strategy, prevalence, risk factors and consequences among older persons. Age Ageing. 2008;37(1):19-24.
• Aslan C, Ulus Y, Akyol Y, Bilgici A, Kuru O. Fear of Falling in Community-Dwelling Older People: Relationship with Sleep Quality, Depression and Quality of Life. .Journal of Physical Medicine and Rehabilitation Science. 2021;24(1):8-16.
• Cho H, Seol SJ, Yoon DH, Kim MJ, Choi BY, Kim T. Disparity in the Fear of Falling Between Urban and Rural Residents in Relation With Socio-economic Variables, Health Issues, and Functional Independency. Ann Rehabil Med. 2013;37(6):848-61.
• Camargos FF, Dias RC, Dias JM, Freire MT. Cross-cultural adaptation and evaluation of the psychometric properties of the Falls Efficacy Scale-International Among Elderly Brazilians (FES-I-BRAZIL). Rev Bras Fisioter. 2010;14(3):237-43.
• Poddubnyy D, Fedorova A, Listing J, Haibel H, Baraliakos X, Braun J, et al. Physical Function and Spinal Mobility Remain Stable Despite Radiographic Spinal Progression in Patients with Ankylosing Spondylitis Treated with TNF-alpha Inhibitors for Up to 10 Years. J Rheumatol. 2016;43(12):2142-8