Pain Medicine Division, PMR Department, School of Medicine, Cukurova University, Adana, Turkey.
PMR Department, Sancaktepe Sehit Prof Dr Ilhan Varank Training and Research Hospital, Istanbul, Turkey.
Rheumatol Int. 2019 Dec;39(12):2043-2051. doi: 10.1007/s00296-019-04419-0. Epub 2019 Aug 21.
Rheumatoid arthritis (RA) involving the cervical spine can lead to various neurologic defects and impairment of proprioception is just one of them. The aim of this study was the assessment of cervical proprioception and its relation with radiographic, clinical, and functional characteristics of patients with RA. One hundred and six rheumatoid arthritis patients who diagnosed according to the 2010 American College of Rheumatology/European League Against Rheumatism criteria and age, gender, educational status matched one hundred and six healthy volunteers were enrolled in this study. Cervical joint position error test (CJPET) was applied to healthy volunteers and RA patients for cervical proprioception assessment. Fatigue, depression, balance, quality of life and balance scales were administered to all patients. Cervical radiography was used to assess cervical subluxations. Regression analysis was used for grading the factors which had relations with cervical proprioception. Mean age of patients and healthy volunteers was 51 ± 11.1 and 48.9 ± 9.2, respectively. Scores of CJPET were statistically significantly higher in RA group than healthy volunteers (p = 0.001). CJPET scores were negatively correlated with Berg balance scale findings in right rotation, left rotation, flexion and extension (rho = - 0.421,- 0.473,- 0.448,- 0.515). There was weak or not significant correlation between the scores of CJPET and fatigue, depression, and quality of life scales. Scores of CJPET in patients with atlantoaxial subluxations (AAS) were statistically significantly higher than those without AAS (p < 0.05). Regression analysis results showed that the AAS was related to impaired cervical proprioception on right and left rotations. There was no correlation between CJPET scores and functional parameters. Cervical proprioception impaired in RA patients. This impairment was related to the existence of AAS and balance problems.
类风湿性关节炎(RA)累及颈椎可导致各种神经缺陷,本体感觉障碍只是其中之一。本研究旨在评估 RA 患者的颈椎本体感觉及其与放射学、临床和功能特征的关系。根据 2010 年美国风湿病学会/欧洲抗风湿病联盟标准诊断的 106 例类风湿关节炎患者和年龄、性别、教育程度匹配的 106 例健康志愿者纳入本研究。颈椎关节位置误差测试(CJPET)用于评估健康志愿者和 RA 患者的颈椎本体感觉。对所有患者进行疲劳、抑郁、平衡、生活质量和平衡量表评估。颈椎放射摄影用于评估颈椎半脱位。回归分析用于评估与颈椎本体感觉相关的因素分级。患者和健康志愿者的平均年龄分别为 51±11.1 和 48.9±9.2。RA 组的 CJPET 评分明显高于健康志愿者(p=0.001)。CJPET 评分与右侧旋转、左侧旋转、前屈和伸展时的 Berg 平衡量表结果呈负相关(rho=-0.421,-0.473,-0.448,-0.515)。CJPET 评分与疲劳、抑郁和生活质量量表之间的相关性较弱或无统计学意义。存在寰枢关节半脱位(AAS)的患者的 CJPET 评分明显高于无 AAS 的患者(p<0.05)。回归分析结果表明,AAS 与右侧和左侧旋转时颈椎本体感觉受损有关。CJPET 评分与功能参数之间无相关性。RA 患者的颈椎本体感觉受损。这种损伤与 AAS 的存在和平衡问题有关。