Büyükaslan A1, Alikaj A1, Tarakçı D1, Uğurlu S2
1Medipol University / Health Sciences Institute, Physical Therapy and Rehabilitation, Istanbul, Turkey, 2Istanbul University / Istanbul Faculty of Medicine, Internal Medicine, Division of Rheumatology, Istanbul, Turkey
Background: Chronic inflammatory disorder can affect the spine and peripheral joint resulting in limitation of mobility, function and consequent postural adaptation. In order to maintain their balance during standing and walking patients tend to adopt a compensatory strategy. Joint erosion, pain and stiffness due to active inflammation lead to a decrease in physical activity, which can lead to a decrease in proprioceptive receptor cells.
Purpose: The aim of this study was to evaluate proprioception and body balance in patients with inflammatory arthropathy and healthy subjects.
Methods: A single-centre prospective cohort study was conducted. Study included 40 patients with inflammatory arthropathy (20 patients with RA, 20 patients with AS) and 20 healthy subjects. Demographic and clinical characteristic information including age, gender, body mass index, disease duration, hip, knee, foot/ankle problems related to inflammatory arthropathy and pain severity were recorded. We assessed body balance and the relationship with lower extremity functional status, in patients with rheumatoid arthritis, ankylosing spondylitis and healthy subjects. Proprioception and balance was measured with Fizyosoft Balance System based on Nintendo WiiFit. Center of balance (COB), changes in movement distance, center of balance in the first, 16th and 30th second during stance position with eyes opened and closed was measured in the anteroposterior and mediolateral direction. Lower extremity functional status were assessed with using Lower Extremity Functional Score (LEFS).
Results: 24 male and 36 female were included in this study. Mean age of rheumatoid arthritis group(RA), ankylosing spondylitis(AS) and healthy group were 46.5±10.5, 38.6±7.0, 40.2±11.1 years, respectively and mean BMI were 29.0±4.4, 25.8±5.0, 27.3±5.7 kg/m2 respectively. There was statistically significant difference between groups in the LEFS. RA group had a higher disability score in the LEFS compared with other groups. There was no difference between the groups in the center of balance (COB), changes in movement distance, center of balance in the first, 16th and 30th second during stance position with eyes opened condition. There was a statistically significant difference only in the 30th second during stance position with eyes closed in the AS group on the mediolateral direction. It is known that in patients with ankylosing spondylitis, anteroposterior balance is distorted, our results suggest that mediolateral stabilization is being achieved as a compensator in order to achieve equilibrium. There was a correlation between changes in movement distance with eyes closed condition and active inflamation of hip, knee, foot and ankle related to inflammatory arthropathy, foot-ankle pain. Proprioception and balance was not directly affected by lower extremity functional status but it was related to impaired lower extremity and foot-ankle pain.
Conclusion(s): Pain and lower extremity problems especially foot-ankle due to inflammatory arthropathy leads to individual changes in the proprioception and balance. Examination of patients with inflammatory arthropathy should include assessment of proprioception, balance and relation to impaired joint.
Implications: For the future researchers and clinicians while planning rehabilitation programmes would be beneficial adding proprioception and balance exercises to the programmes to prevent loss of function due to erosive arthritis. Strengthening exercises targeted at muscle groups involved in postural alignment should use in the practice.
Keywords: proprioception, balance, inflammatory arthropathy
Funding acknowledgements: No funding to declare
Purpose: The aim of this study was to evaluate proprioception and body balance in patients with inflammatory arthropathy and healthy subjects.
Methods: A single-centre prospective cohort study was conducted. Study included 40 patients with inflammatory arthropathy (20 patients with RA, 20 patients with AS) and 20 healthy subjects. Demographic and clinical characteristic information including age, gender, body mass index, disease duration, hip, knee, foot/ankle problems related to inflammatory arthropathy and pain severity were recorded. We assessed body balance and the relationship with lower extremity functional status, in patients with rheumatoid arthritis, ankylosing spondylitis and healthy subjects. Proprioception and balance was measured with Fizyosoft Balance System based on Nintendo WiiFit. Center of balance (COB), changes in movement distance, center of balance in the first, 16th and 30th second during stance position with eyes opened and closed was measured in the anteroposterior and mediolateral direction. Lower extremity functional status were assessed with using Lower Extremity Functional Score (LEFS).
Results: 24 male and 36 female were included in this study. Mean age of rheumatoid arthritis group(RA), ankylosing spondylitis(AS) and healthy group were 46.5±10.5, 38.6±7.0, 40.2±11.1 years, respectively and mean BMI were 29.0±4.4, 25.8±5.0, 27.3±5.7 kg/m2 respectively. There was statistically significant difference between groups in the LEFS. RA group had a higher disability score in the LEFS compared with other groups. There was no difference between the groups in the center of balance (COB), changes in movement distance, center of balance in the first, 16th and 30th second during stance position with eyes opened condition. There was a statistically significant difference only in the 30th second during stance position with eyes closed in the AS group on the mediolateral direction. It is known that in patients with ankylosing spondylitis, anteroposterior balance is distorted, our results suggest that mediolateral stabilization is being achieved as a compensator in order to achieve equilibrium. There was a correlation between changes in movement distance with eyes closed condition and active inflamation of hip, knee, foot and ankle related to inflammatory arthropathy, foot-ankle pain. Proprioception and balance was not directly affected by lower extremity functional status but it was related to impaired lower extremity and foot-ankle pain.
Conclusion(s): Pain and lower extremity problems especially foot-ankle due to inflammatory arthropathy leads to individual changes in the proprioception and balance. Examination of patients with inflammatory arthropathy should include assessment of proprioception, balance and relation to impaired joint.
Implications: For the future researchers and clinicians while planning rehabilitation programmes would be beneficial adding proprioception and balance exercises to the programmes to prevent loss of function due to erosive arthritis. Strengthening exercises targeted at muscle groups involved in postural alignment should use in the practice.
Keywords: proprioception, balance, inflammatory arthropathy
Funding acknowledgements: No funding to declare
Topic: Rheumatology; Outcome measurement
Ethics approval required: Yes
Institution: Medipol University
Ethics committee: Medipol University Non-invasive Clinical Research Ethics Committee
Ethics number: 10840098
All authors, affiliations and abstracts have been published as submitted.
