类风湿关节炎患者的平衡和预期跌倒。
Balance and prospective falls in patients with rheumatoid arthritis.
机构信息
Department of Radiology, Centre for Muscle and Bone Research, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Hindenburgdamm 30, 12200, Berlin, Germany.
Deutsche Rheuma-Liga Bundesverband e.V., Welschnonnenstraße 7, 53111, Bonn, Germany.
出版信息
BMC Musculoskelet Disord. 2022 Jun 7;23(1):549. doi: 10.1186/s12891-022-05489-1.
BACKGROUND
Postural control is associated with fall risk. Patients with rheumatoid arthritis (RA) have a higher risk to fall than healthy subjects. The objective of this study was to identify associations between variables of postural control with prospective falls in patients with RA.
METHODS
For the baseline, the balance performance of 289 men and women with RA, ages 24-85 years, was evaluated by SPPB, FICSIT-4 and Romberg tests. Postural sway for Romberg, semitandem, tandem and one-leg stands were measured with the Leonardo Mechanograph®. Self-reported disability was assessed using the Health Assessment Questionnaire (HAQ) and the Activity-specific Balance Confidence Scale (ABC-scale). Falls were reported in quarterly reports over a year. Univariate and multiple logistic regression analysis were used to explore any associations with falling. Receiver-operating characteristics were determined, and the area under the curve is reported.
RESULTS
A total of 238 subjects completed the 1-year follow-up, 48 (20.2%) experienced at least one fall during the observational period. Age (OR = 1.04, CI 1.01-1.07), HAQ (OR = 1.62, 1.1-2.38), FICSIT-4 scoring 0-4 (OR = 2.38, 1.13-5.0), and one-leg standing (OR = 2.14, 1.06-4.31) showed significant associations with falls. With regard to the SPPB and ABC-scale, no statistically significant associations with falls were found. The quartiles containing the worst results of medio-lateral sway of Romberg (OR = 2.63, CI 1.03-6.69), total sway of semitandem (OR = 3.07, CI 1.10-8.57) and tandem (OR = 2.86, CI 1.06-7.69), and area of sway of semitandem (OR = 2.80, CI 1.11-7.08) stands were associated with falls.
CONCLUSIONS
The assessment of a one-leg stand seems to be a good screening tool to discriminate between high and low risk of falls in RA patients in clinical practice. A low FICSIT-4 score and several sway parameters are important predictors of falls.
TRIAL REGISTRATION
The study has been registered at the German Clinical Trials Register and the WHO International Clinical Trials Registry Platform (ICTRP) since 16 March 2017 ( DRKS00011873 ).
背景
姿势控制与跌倒风险相关。类风湿关节炎（RA）患者跌倒的风险高于健康受试者。本研究的目的是确定 RA 患者姿势控制变量与前瞻性跌倒之间的关联。
方法
在基线时，使用 SPPB、FICSIT-4 和 Romberg 测试评估了 289 名年龄在 24-85 岁之间的男性和女性 RA 患者的平衡表现。使用 Leonardo Mechanograph®测量 Romberg、半足距站立、全足距站立和单足距站立的姿势摆动。使用健康评估问卷（HAQ）和活动特异性平衡信心量表（ABC 量表）评估自我报告的残疾情况。在一年的时间里，每季度报告一次跌倒情况。使用单变量和多变量逻辑回归分析来探索与跌倒相关的任何关联。确定了受试者工作特征曲线，报告了曲线下面积。
结果
共有 238 名受试者完成了为期 1 年的随访，48 名（20.2%）在观察期内至少发生了 1 次跌倒。年龄（OR=1.04，95%CI 1.01-1.07）、HAQ（OR=1.62，95%CI 1.1-2.38）、FICSIT-4 评分 0-4（OR=2.38，95%CI 1.13-5.0）和单腿站立（OR=2.14，95%CI 1.06-4.31）与跌倒显著相关。对于 SPPB 和 ABC 量表，与跌倒无统计学显著关联。罗伯格（Romberg）的左右摆动中间值最差（OR=2.63，95%CI 1.03-6.69）、半足距站立（OR=3.07，95%CI 1.10-8.57）和全足距站立（OR=2.86，95%CI 1.06-7.69）总摆动和半足距站立（OR=2.80，95%CI 1.11-7.08）摆动面积的四分位数与跌倒相关。
结论
单腿站立评估似乎是一种很好的筛选工具，可以在临床实践中区分 RA 患者跌倒的高风险和低风险。低 FICSIT-4 评分和几个摆动参数是跌倒的重要预测因素。
试验注册
该研究自 2017 年 3 月 16 日起在德国临床试验注册处和世界卫生组织国际临床试验注册平台（ICTRP）进行注册（DRKS00011873）。
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