Background/Purpose:  Lower extremity arthritis, proprioceptive dysfunction related to foot deformities, muscle weakness, joint restrictions, biomechanical disoerders, fatigue, sleep disorders, depression, and pain are frequently seen in patients with romatoid arthritis and may affect the balance. The aim of this study to evaluate the static and dynamic balances of the patients diagnosed with rheumatoid arthritis (RA) and also to disclose the relationship between these parameters and clinical, functional and radiological findings.

Methods:  Patients diagnosed with RA according to ACR 2010 diagnostic criteria were compared with age and gender matched healthy controls. The age, sex and body mass index (BMI) data of the cases were recorded. DAS-28 score was calculated for determining the disease activity and the detailed rheumatologic and musculoskeletal examination was performed. Radiographic assessments of feet were done to evaluate the presence of pes planus, hallux valgus, metatarsus primus varus and splaying foot deformities. ‘Foot and Ankle Outcome Score’ (FAOS) was applied for foot function assessment. The level of fatigue, depression and sleep disorders of all patients were determined with ‘Multidimentional Assessment of Fatigue’, ‘Beck Depression Inventory’ and ‘Pittsburgh Sleep Quality Index’, respectively. The state of balance of the patients was evaluated by means of ‘Berg Balance Scale’ (BBS) and also 3 static (Modified Clinical Test of Sensory Interaction and Balance, Unilateral Stance , Weight Bearing Squat) and 4 dynamic ( Step Up/Over, Sit to Stand, Tandem Walk, Limits of Stability) balance tests with 30 parameters were assessed via the ‘Neurocom Balance Master’ device available in our clinic. Statistical analyses were performed with SPSS version 22 and p values less than 0.05 were considered statistically significant.

Results:  This study included 165 cases that consist of 81 RA group (66 female, 15 male) and 84 healthy control group (70 female, 14 male). The mean age of patients and controls were 48.90±10.36 and 45.89±12.07 years, respectively. Age, sex and BMI data of both groups were similar between (p>0.05). The mean score of DAS­28 of patients were 3,69±1,17. There were significant differences in the results of Modified Clinical Test of Sensory Interaction and Balance, Unilateral Stance, Tandem Walk, Limits of Stability, Step Up/Over tests between the patient and the control groups (p<0.05). Sit to Stand and Weight Bearing Squat test results were similar (p>0.05). It was deduced that 66.7% of patients have depression, 64.2% sleep disorders and 93.8% fatigue according to surveys; however there was no correlation between these symptoms and presence of balance disorders. Although 61% of patients were established with hallux valgus, 52% metatarsus primus varus, 33% pes planus, 26% splaying foot, these deformities were not correlated with FAOS and balance disorders. The presence of the swollen joint was determined as the most relevant factor about the balance disorders of RA patients.

Conclusion:  Patients diagnosed with RA may have balance disorders as an important finding independently from other findings and symptoms during the course of the disease.

« Back to 2016 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/assessment-of-the-relationship-of-the-static-and-dynamic-balance-parameters-with-clinical-functional-and-radiological-findings-in-patients-with-rheumatoid-arthritis/