Alkan Melikoğlu Meltem, Bağcier Fatih
Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Medical Faculty of Atatürk University, Erzurum, Turkey.
Department of Physical Medicine and Rehabilitation, Medical Faculty of Atatürk University, Erzurum, Turkey.
Arch Rheumatol. 2017 Apr 4;32(3):216-220. doi: 10.5606/ArchRheumatol.2017.6079. eCollection 2017 Sep.
This study aims to determine the fall risk in systemic lupus erythematosus (SLE) patients with an objective computerized technique and to evaluate the potential related risk factors for falls in these patients.
A total of 48 female patients (mean age 37.8±12.6 years; range 18 to 65 years) with SLE and 30 female controls (mean age 39.1±15.7 years; range 19 to 66 years) were included. Age, disease duration, anamnesis of falls, fear of falling, and drugs used were recorded. Disease activity (measured with SLE disease activity index Safety of Estrogens in Lupus Erythematosus National Assessment modification) and damage (measured with Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index) were evaluated. For the evaluation of fall efficacy, we used the Falls Efficacy Scale International. Fall risk analysis was performed by using a computerized posturography device.
Seven patients (15%) had anamnesis of falls during the last 12 months, whereas only one control (3%) had this anamnesis (p=0.042). Fear of falling was reported by 40% of the patients and 30% of the controls (p=0.042). Falls Efficacy Scale International scores were found to be higher in patients than in controls (p=0.042). With the computerized system used, higher fall risk results were recorded in patients than in controls (59.3±29.5 and 35.8±26.9, respectively; p<0.001). Low, moderate, and high fall risks were recorded as 31%, 15%, and 54% in the patients, respectively, and as 53%, 23%, and 23% in the controls, respectively. Low, moderate and high fall risk distribution was also worse in patients than in the controls (p=0.030). No significant correlation was found between fall risk and the other factors evaluated, except Falls Efficacy Scale International, which was significantly correlated with both fall risk assessment and fall risk category in the patients (r=0.311, p=0.031).
Fall risk was found to be higher in SLE patients than in controls. The higher fall risk in these patients seems to be affected by the disease itself rather than its other characteristics. Future studies investigating the possible coexisting balance problems in SLE may contribute to the management of the disease.
本研究旨在采用客观的计算机技术确定系统性红斑狼疮（SLE）患者的跌倒风险，并评估这些患者跌倒的潜在相关危险因素。
共纳入48例SLE女性患者（平均年龄37.8±12.6岁；年龄范围18至65岁）和30例女性对照者（平均年龄39.1±15.7岁；年龄范围19至66岁）。记录年龄、病程、跌倒史、跌倒恐惧及所用药物。评估疾病活动度（采用系统性红斑狼疮疾病活动指数-雌激素在狼疮中的安全性国际评估修订版进行测量）和损伤情况（采用系统性红斑狼疮国际协作临床研究/美国风湿病学会损伤指数进行测量）。为评估跌倒效能，我们使用了国际跌倒效能量表。采用计算机化姿势描记装置进行跌倒风险分析。
7例患者（15%）在过去12个月中有跌倒史，而对照者中只有1例（3%）有此病史（p=0.042）。40%的患者和30%的对照者报告有跌倒恐惧（p=0.042）。发现患者的国际跌倒效能量表得分高于对照者（p=0.042）。使用计算机系统记录到，患者的跌倒风险结果高于对照者（分别为59.3±29.5和35.8±26.9；p<0.001）。患者中低、中、高跌倒风险分别记录为31%、15%和54%，对照者中分别为53%、23%和23%。患者的低、中、高跌倒风险分布也比对照者差（p=0.030）。除国际跌倒效能量表外，未发现跌倒风险与其他评估因素之间存在显著相关性，而国际跌倒效能量表与患者的跌倒风险评估及跌倒风险类别均显著相关（r=0.311，p=0.031）。
发现SLE患者的跌倒风险高于对照者。这些患者较高的跌倒风险似乎受疾病本身影响，而非其其他特征。未来研究SLE中可能并存的平衡问题可能有助于该疾病的管理。
