The influence of physical function on the risk of falls among adults with
               rheumatoid arthritis

Marques, Wanessa Vieira; Cruz, Vitor Alves; Rego, Jozelia; Silva, Nilzio Antonio da

doi:10.1016/j.rbr.2014.03.019

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Revista Brasileira de Reumatologia

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Sumário

Brief Communications • Rev. Bras. Reumatol. 54 (5) • Sep-Oct 2014 • https://doi.org/10.1016/j.rbr.2014.03.019 copy

The influence of physical function on the risk of falls among adults with rheumatoid arthritis^☆ ☆ Rheumatology Service, Department of Internal Medicine, Hospital das Clínicas, Medicine School, Universidade Federal de Goiás.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objectives:

Identify fall prevalence in the last 12 months among patients with rheumatoid arthritis (RA) and verify the influence of disease activity and physical function in the risk of falls.

Methods:

43 patients with RA participated in this study. The following parameters were evaluated: clinical aspects; fall occurrence in the last 12 months; ESR (mm/h); pain on a visual analogue scale (VAS) ranging from 0 to 10 cm; disease activity, measured by the Disease Activity Score 28/ESR (DAS-28/ESR); physical function, assessed by the Health Assessment Questionnaire (HAQ); and risk of falling, assessed by two tests, the 5-time sit down-to-stand up test (SST5) and the get up and go timed test (GUGT).

Results:

The fall prevalence in the last 12 months was 30.2% (13/43). The HAQ total score was the independent risk factor that had significant influence on SST5 performance, and the other variables did not succeeded to explain the SST5 variability. HAQ explained 42.9% of SST5 variability (P < 0.001, adjusted R² = 0.429). HAQ total score and ESR had a significant influence on GUGT score performance. Together, these two variables explained 68.8% of the total variation in GUGT score (adjusted R² = 0.688).

Conclusion:

Patients with RA have high fall prevalence and the functional disability represents the main factor related to falls risk.

Rheumatoid arthritis; Falls; Functional capacity; Disease activity

Characteristic		Value
Patients, n		43
Women, n (%)		37 (86.0%)
Positivity for rheumatoid factor, n (%)		26 (60.5%)
Age (years), mean ± SD (min-max)		58.7 ± 9.1 (43-80)
Self-reported color, n (%)
	White	18 (41.9%)
	Black	8 (18.6%)
	Mixed (brown)	17 (39.5%)
Disease duration (years), mean ± SD (min-max)		12.2 ± 9.1 (1-30)
Use of a gait supportive gear, n (%)		8 (18.6%)
Presence of arthroplasty (knee and/or hip), n (%)		3 (7.0%)
HAQ, mean ± SD (min-max)		1.15 ± 0.78 (0-3)
DAS-28, mean ± SD (min-max)		4.01 ± 1.31 (0.8-6.8)
ESR (mm/h), mean ± SD (min-max)		29.86 ± 22.11 (3-118)
Pain by VAS (cm), mean ± SD (min-max)		4.74 ± 2.52 (0-10)
SST5 (seconds), mean ± SD (min-max)		15.07 ± 5.81 (8.3-25)
GUGT (seconds), mean ± SD (min-max)		17.40 ± 11.61 (9.2-60)
Smokers or ex-smokers, n (%)		24 (55,8%)
Practicing physical activity n (%)		6 (14.0%)

Variable	SST5				GUGT
	exp (β)	P-value	95% CI	R²	exp (p)	P-value	95% CI	R²
Age (years)	1.012	0.052	[1.000-1.025]	0.070	1.017	0.116	[0.996 - 1.038]	0.046
Disease duration (years)	1.013	0.045	[1.001-1.025]	0.075	1.012	0.305	[0.990 - 1.034]	0.002
ESR (mm/h)	1.005	0.032	[1.001-1.01]	0.083	1.012	0.001	[1.005-1.018]	0.250
Pain by VAS (cm)	1.021	0.398	[0.974 - 1.069]	0.000	1.015	0.729	[0.935 - 1.101]	0.000
Number of comorbidities	1.058	0.041	[1.004-1.115]	0.078	1.095	0.06	[0.999 - 1.199]	0.079
Presence of arthroplasty	1.158	0.506	[0.755 - 1.777]	0.000	1.859	0.038	[1.056-3.273]	0.083
Positive rheumatoid factor	0.932	0.561	[0.736 - 1.18]	0.000	0.889	0.574	[0.592 - 1.335]	0.000
DAS-28	1.06	0.215	[0. 968 - 1.159]	0.015	1.11	0.185	[0.954 - 1.292]	0.025
HAQ	1.365	< 0.001	[1.227-1.518]	0.429	1.796	< 0.001	[1.585-2.035]	0.665

Variable	SST5				GUGT
	exp (β)	P-value	95% CI	Adjusted R²	exp (β)	P-value	95% CI	Adjusted R²
HAQ	1.365	< 0.001	[1.227-1.518]	0.429	1.684	< 0.001	[1.471-1.928]	0.688
ESR (mm/h)	-	-	-	-	1.004	0.0477	[1.001-1.008]	0.688

Sociedade Brasileira de Reumatologia Av Brigadeiro Luiz Antonio, 2466 - Cj 93., 01402-000 São Paulo - SP, Tel./Fax: 55 11 3289 7165 - São Paulo - SP - Brazil
E-mail: sbre@terra.com.br

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[1] * Corresponding author. E-mail: wanessavmarques@yahoo.com.br (W.V. Marques).

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The influence of physical function on the risk of falls among adults with rheumatoid arthritis☆ ☆ Rheumatology Service, Department of Internal Medicine, Hospital das Clínicas, Medicine School, Universidade Federal de Goiás.

Objectives:

Methods:

Results:

Conclusion:

The influence of physical function on the risk of falls among adults with rheumatoid arthritis^☆ ☆ Rheumatology Service, Department of Internal Medicine, Hospital das Clínicas, Medicine School, Universidade Federal de Goiás.