Balance and prospective falls in patients with rheumatoid arthritis

  • 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.

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Author:Sabine Wiegmann, Gabriele ArmbrechtORCiDGND, Diana Borucki, Björn BühringORCiDGND, Frank ButtgereitORCiDGND, Christian Detzer, Desirée SchaumburgGND, Kim Nikola ZeinerGND, Roswitha DietzelORCiDGND
Parent Title (English):BMC musculoskeletal disorders
Publisher:BioMed Central
Place of publication:London
Document Type:Article
Date of Publication (online):2022/06/07
Date of first Publication:2022/06/07
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2023/01/09
Tag:Balance; Fall; One-leg stand; Postural control; Postural sway; Rheumatoid arthritis
Issue:art. 549
Article Number:549
Page Number:21
First Page:1
Last Page:21
Availability of data and materials
The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.
This project received financial support by the Deutsche Rheuma-Liga Bundesverband e.V. and from the Stiftung Wolfgang Schulze. The publication was supported by the German Research Foundation (DFG) and the Open Access Publication Fund of Charité – Universitätsmedizin Berlin. Open Access funding enabled and organized by Projekt DEAL.
The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - CC BY - Namensnennung 4.0 International