Prevent Falls in RA Patients Using Simple Tool

Patients with rheumatoid arthritis (RA) have been shown in previous studies to be at a higher risk of falling than those without the disease. A team of German researchers set out to identify associations between postural control and prospective falls in patients with RA.

Their work, “Balance and prospective falls in patients with rheumatoid arthritis,” appears in the June 7, 2022, edition of BMC Musculoskeletal Disorders.

The researchers noted in their article that several things are at play when it comes to RA patients and falls, including joint pain and swelling, joint deformations joints, and declining of muscle function.

Co-author Sabine Wiegmann, with the Department of Radiology, Centre for Muscle and Bone Research, Charité – Universitätsmedizin in Berlin, explained that this work actually dovetailed with her Ph.D. thesis. “This study is part of my Ph.D. thesis which covers the topic of sarcopenia. Research is still lacking consensus on the complex phenomenon of sarcopenia, particularly the significance of the early decline in muscle function and its association with adverse outcomes.”

OTW asked Dr. Wiegmann to explain why we lack data on falls in RA patients and she said, “Prospective studies are often not performed due to lack of time and financial resources. Further, the innovative device, Leonardo Mechanograph, is not well known, yet.”

The current study, which included 238 RA patients between 24 and 85 years of age, measured postural sway with the Leonardo Mechanograph, a gait analysis tool. Patients self-reported on their disability using the Health Assessment Questionnaire and the Activity-specific Balance Confidence Scale.

The researchers found that 48 patients (20.2%) had at least one fall during the study. Several items showed significant associations with falls: age, Health Assessment Questionnaire, Frailty and Injuries: Cooperative Studies of Intervention Techniques-4 (scoring 0–4), and one-leg standing.

“Our study determined that one-leg stand is an appropriate screening tool for fall risk in patients with rheumatoid arthritis,” Wiegmann told OTW. “The fall risk is increased if a 10-second one-leg stand is failed. The training of medio-lateral and anterior-posterior balance strategies should be the focus of fall prevention strategies and the therapy of fallers.”

“Rheumatologists and orthopedic surgeons should screen for fall risk by using a quick and easy test: the one-leg stand and should initiate preventive measures like functional training for patients of high risk.”