Hayashibara M, Hagino H, Katagiri H, Okano T, Okada J, Teshima R
Department of Orthopedic Surgery, Faculty of Medicine, Tottori University, Yonago, Tottori, 683-8504, Japan.
Osteoporos Int. 2010 Nov;21(11):1825-33. doi: 10.1007/s00198-009-1150-4. Epub 2010 Jan 30.
A prospective 1-year study showed that fall incidence was 50% in women with rheumatoid arthritis. Multivariate analysis identified swollen joint count, use of antihypertensives or diuretics, one-leg standing time, and sway area measured by stabilometer as significant parameters associated with falls.
Patients with rheumatoid arthritis (RA) may be at increased risk of falling because they frequently experience muscle weakness and stiff or painful joints. The aim of this study was to use a prospective design to determine the incidence of falls and their risk factors in women with RA.
Eighty-four women aged 50 and over who had RA were enrolled. The mean age was 64.1 years. We evaluated postural stability, physical performance related to falls, disease activity, muscle volume, and bone density. The occurrence of falls was assessed every month for 1 year. Among 84 patients, 80 completed a 1-year observation.
Forty patients (50.0%) reported one or more falls, and two of them (5.0%) had fractures during the follow-up period. The fall group had more swollen joints and took more antihypertensives and/or diuretics. The fall group also had lower postural stability and tended to have reduced physical performance. The one-leg standing time was shorter, and the step-up-and-down test score was lower in the fall group. The sway area was larger in the fall group.
Multiple logistic regression analysis identified that number of swollen joints, use of antihypertensives or diuretics, shorter time standing on one foot, and the sway area were the most significant parameters associated with falls.
We concluded that fall rates in RA patients were higher than in the general population and that balance impairment or side effects of drugs may play a role in increasing the risk of falls.
一项为期1年的前瞻性研究表明,类风湿关节炎女性的跌倒发生率为50%。多变量分析确定,肿胀关节计数、使用抗高血压药或利尿剂、单腿站立时间以及用稳定仪测量的摆动面积是与跌倒相关的重要参数。
类风湿关节炎(RA)患者可能因经常出现肌肉无力以及关节僵硬或疼痛而跌倒风险增加。本研究的目的是采用前瞻性设计来确定RA女性的跌倒发生率及其危险因素。
招募了84名年龄在50岁及以上的患有RA的女性。平均年龄为64.1岁。我们评估了姿势稳定性、与跌倒相关的身体机能、疾病活动度、肌肉量和骨密度。对跌倒的发生情况进行了为期1年的每月评估。84名患者中,80名完成了1年的观察。
40名患者(50.0%)报告有一次或多次跌倒,其中两名(5.0%)在随访期间发生骨折。跌倒组有更多肿胀关节,服用更多抗高血压药和/或利尿剂。跌倒组的姿势稳定性也较低,身体机能往往有所下降。跌倒组的单腿站立时间较短,上下台阶测试得分较低。跌倒组的摆动面积较大。
多因素逻辑回归分析确定,肿胀关节数量、使用抗高血压药或利尿剂、单脚站立时间较短以及摆动面积是与跌倒相关的最显著参数。
我们得出结论,RA患者的跌倒率高于一般人群,平衡功能受损或药物副作用可能在增加跌倒风险中起作用。