Yıl: 2013 Cilt: 28 Sayı: 2 Sayfa Aralığı: 109 - 116 Metin Dili: Türkçe

Fall Risk in Patients with Ankylosing Spondylitis

Öz:
Amaç: Bu çalışmada, ankilozan spondilitli (AS) hastaların sağlıklı bireylerden daha fazla düşme riskine sahip olup olmadığı ve düşme riski ile AS'nin klinik özellikleri arasında herhangi bir ilişki olup olmadığı araştırıldı.Hastalar ve yöntemler: Modifiye New York kriterlerine uyan AS'li 40 hasta (28 erkek, 12 kadın; ort yaş 37.20±9.92 yıl; dağılım 20-60 yıl) ile yaşları ve cinsiyetleri eşleştirilmiş 40 sağlıklı kontrol çalışmaya dahil edildi. Tüm katılımcılar, düşme riski yüzdesi olarak bize sayısal değerler sunan statik posturografi cihazı ile değerlendirildi. Hasta görüşmelerinden son 12 ay içindeki düşme öyküsü de belirlendi. Tüm AS hastalarına şu araçlar uygulandı: hastalık aktivitesi için Bath Ankilozan Spondilit Hastalık Aktivite İndeksi (BASDAI), fonksiyon için Bath Ankilozan Spondilit Hastalık Fonksiyonel İndeksi (BASFI), spinal mobilite için Bath Ankilozan Spondilit Metroloji İndeksi (BASMI) ve yaşam kalitesi için Ankilozan Spondilit Yaşam Kalitesi (ASQoL) anketi.Bulgular: Ankilozan spondilitli hastalar ile sağlıklı kontroller arasında sosyodemografik özellikler bakımından fark yoktu (p>0.05). Ortalama düşme riski, AS'li hastalarda kontrollere kıyasla, anlamlı olarak yüksekti (p<0.05). Ankilozan spondilitli hastalarda pozitif düşme öyküsüne sahip olanların oranı kontrollerden yüksekti (p<0.05). Düşme riski ile BASDAI (r=0.713, p<0.001), BASFI (r=0.751, p<0.001), BASMI (r=0.527, p<0.001) ve ASQoL (r=0.627, p<0.001) arasında pozitif ve anlamlı ilişki vardı. Düşme riski yaş, cinsiyet, vücut kütle indeksi ve hastalık süresiyle ilişkili bulunmadı (p>0.05).Sonuç: Ankilozan spondilitli hastalarda kötü spinal mobilite, fonksiyonel durum, yaşam kalitesi ve yüksek hastalık aktivitesi ile ilişkili olan düşme riski artmıştır. Yüksek olan düşme riski AS'li hastaların rehabilitasyonunda dikkate alınmalıdır.
Anahtar Kelime:

Konular:
Fen > Tıp > Romatoloji

Ankilozan Spondilitli Hastalarda Düşme Riski

Öz:
Objectives: The aim of this study was to investigate whether patients with ankylosing spondylitis (AS) have a higher fall risk than healthy subjects and to determine whether fall risk is associated with the clinical features of AS. Patients and methods: Forty AS patients (28 males, 12 females; mean age 37.20±9.92 years; range 20 to 60 years) who met the modified New York criteria and 40 age and gender-matched healthy controls were included. All participants were assessed by a static posturography device which provided numerical values in the percentage for fall risk. Patient interviews were used to assess the history of falls for the previous 12 months. The following tools were used for all AS patients: The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for disease activity, the Bath Ankylosing Spondylitis Functional Index (BASFI) for function, the Bath Ankylosing Spondylitis Metrology Index (BASMI) for spinal mobility, and the Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire for quality of life. Results: There were no differences in the sociodemographic characteristics among the AS patients and the healthy controls (p>0.05). The mean fall risk was significantly higher for the AS patients compared to the controls (p<0.05). The ratio of AS patients who had a positive history of falls was significantly higher than controls (p<0.05). Fall risk was positively and significantly associated with the BASDAI (r=0.713, p<0.001), BASFI (r=0.751, p<0.001), BASMI (r=0.527, p<0.001), and ASQoL (r=0.627, p<0.001). The fall risk was not associated with the age, sex, body mass index and disease duration (p>0.05). Conclusion: Fall risk increased in patients with AS which was associated with poor spinal mobility, functional status, quality of life and higher disease activity. Increased risk of falling should be taken into consideration in the rehabilitation of the patients with AS.
Anahtar Kelime:

Konular:
Fen > Tıp > Romatoloji
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • Gran JT, Husby G. The epidemiology of ankylosing spondylitis. Semin Arthritis Rheum 1993;22:319-34.
  • Sieper J, Braun J, Rudwaleit M, Boonen A, Zink A. Ankylosing spondylitis: an overview. Ann Rheum Dis 2002;61 Suppl 3:iii8-18.
  • McLeod C, Bagust A, Boland A, Dagenais P, Dickson R, Dundar Y, et al. Adalimumab, etanercept and infliximab for the treatment of ankylosing spondylitis: a systematic review and economic evaluation. Health Technol Assess 2007;11:1-158, iii-iv.
  • Khan MA. Ankylosing spondylitis--the history of medical therapies. Clin Exp Rheumatol 2002;20:S3-5.
  • Murray HC, Elliott C, Barton SE, Murray A. Do patients with ankylosing spondylitis have poorer balance than normal subjects? Rheumatology (Oxford) 2000;39:497-500.
  • Aydog E, Depedibi R, Bal A, Eksioglu E, Unlü E, Cakci A. Dynamic postural balance in ankylosing spondylitis patients. Rheumatology (Oxford) 2006;45:445-8.
  • Adam M, Leblebici B, Erkan AN, Bagıs S, Akman MN. Ankylosing spondylitis and postural balance. Rheumatism 2008;23:87-90.
  • Durmus B, Altay Z, Ersoy Y, Baysal O, Dogan E. Postural stability in patients with ankylosing spondylitis. Disabil Rehabil 2010;32:1156-62. doi: 10.3109/09638280903428310.
  • Vergara ME, O'Shea FD, Inman RD, Gage WH. Postural control is altered in patients with ankylosing spondylitis. Clin Biomech (Bristol, Avon) 2012;27:334-40. doi: 10.1016/j.clinbiomech.2011.10.016.
  • Ozdemir O, Gökce Kutsal Y. Fall risk assessment of elderly by using posturography. Turkish Journal of Geriatrics 2009;12:177-80.
  • Dıracoglu D, Cihan C, Issever H, Aydın R. Postural performance in patients with cervical radiculopaty. Turk J Phys Med Rehab 2009;55:153-7.
  • Alkan H, Topuz O, Yıldız N, Alkan S, Sarsan A, Ardıç F. Efficacy of home-based exercise program and postural biofeedback therapy in reducing risk of falling among osteoporotic women over 65 years of age. Turkish Journal of Geriatrics 2011;14:26-34.
  • van der Linden S, Valkenburg HA, Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum 1984;27:361-8.
  • Gibson MJ, Andres RO, Isaacs B, Radebaugh T, Worm- Petersen J. The prevention of falls in later life. A report of the Kellogg International Work Group on the prevention of falls by the elderly. Dan Med Bull 1987;34(Suppl 4):1-24.
  • Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A. A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index. J Rheumatol 1994;21:2286-91.
  • Calin A, Garrett S, Whitelock H, Kennedy LG, O'Hea J, Mallorie P, et al. A new approach to defining functional ability in ankylosing spondylitis: the development of the Bath Ankylosing Spondylitis Functional Index. J Rheumatol 1994;21:2281-5.
  • Akkoc Y, Karatepe AG, Akar S, Kirazli Y, Akkoc N. A Turkish version of the Bath Ankylosing Spondylitis Disease Activity Index: reliability and validity. Rheumatol Int 2005;25:280-4.
  • Yanik B, Gürsel YK, Kutlay S, Ay S, Elhan AH. Adaptation of the Bath Ankylosing Spondylitis Functional Index to the Turkish population, its reliability and validity: functional assessment in AS. Clin Rheumatol 2005;24:41-7.
  • Jenkinson TR, Mallorie PA, Whitelock HC, Kennedy LG, Garrett SL, Calin A. Defining spinal mobility in ankylosing spondylitis (AS). The Bath AS Metrology Index. J Rheumatol 1994;21:1694-8.
  • Doward LC, Spoorenberg A, Cook SA, Whalley D, Helliwell PS, Kay LJ, et al. Development of the ASQoL: a quality of life instrument specific to ankylosing spondylitis. Ann Rheum Dis 2003;62:20-6.
  • Alpini D, Kohen-Ratz R, Braun R, Burstin A, Tesio L, Pugnetti L, et al. Falls in the elderly: the development of a risk questionnaire and posturographic findings. Int Tinnitus J 2001;7:105-8.
  • Lord SR, Clark RD, Webster IW. Physiological factors associated with falls in an elderly population. J Am Geriatr Soc 1991;39:1194-200.
  • Buatois S, Gueguen R, Gauchard GC, Benetos A, Perrin PP. Posturography and risk of recurrent falls in healthy non-institutionalized persons aged over 65. Gerontology 2006;52:345-52.
  • Alaranta H, Luoto S, Konttinen YT. Traumatic spinal cord injury as a complication to ankylosing spondylitis. An extended report. Clin Exp Rheumatol 2002;20:66-8.
  • Jacobs WB, Fehlings MG. Ankylosing spondylitis and spinal cord injury: origin, incidence, management, and avoidance. Neurosurg Focus 2008;24:E12. doi: 10.3171/ FOC/2008/24/1/E12.
  • Cooper C, Carbone L, Michet CJ, Atkinson EJ, O'Fallon WM, Melton LJ 3rd. Fracture risk in patients with ankylosing spondylitis: a population based study. J Rheumatol 1994;21:1877-82.
APA ALKAN H, YILDIZ N, SARSAN A, ŞİMŞİR ATALAY N, SEVİNÇ Ö, TOPUZ O, ARDIÇ F (2013). Fall Risk in Patients with Ankylosing Spondylitis. Turkish Journal of Rheumatology(.)Archives of Rheumatology, 28(2), 109 - 116.
Chicago ALKAN HAKAN,YILDIZ Necmettin,SARSAN AYŞE,ŞİMŞİR ATALAY Nilgün,SEVİNÇ ÖZGÜR,TOPUZ OYA,ARDIÇ FÜSUN Fall Risk in Patients with Ankylosing Spondylitis. Turkish Journal of Rheumatology(.)Archives of Rheumatology 28, no.2 (2013): 109 - 116.
MLA ALKAN HAKAN,YILDIZ Necmettin,SARSAN AYŞE,ŞİMŞİR ATALAY Nilgün,SEVİNÇ ÖZGÜR,TOPUZ OYA,ARDIÇ FÜSUN Fall Risk in Patients with Ankylosing Spondylitis. Turkish Journal of Rheumatology(.)Archives of Rheumatology, vol.28, no.2, 2013, ss.109 - 116.
AMA ALKAN H,YILDIZ N,SARSAN A,ŞİMŞİR ATALAY N,SEVİNÇ Ö,TOPUZ O,ARDIÇ F Fall Risk in Patients with Ankylosing Spondylitis. Turkish Journal of Rheumatology(.)Archives of Rheumatology. 2013; 28(2): 109 - 116.
Vancouver ALKAN H,YILDIZ N,SARSAN A,ŞİMŞİR ATALAY N,SEVİNÇ Ö,TOPUZ O,ARDIÇ F Fall Risk in Patients with Ankylosing Spondylitis. Turkish Journal of Rheumatology(.)Archives of Rheumatology. 2013; 28(2): 109 - 116.
IEEE ALKAN H,YILDIZ N,SARSAN A,ŞİMŞİR ATALAY N,SEVİNÇ Ö,TOPUZ O,ARDIÇ F "Fall Risk in Patients with Ankylosing Spondylitis." Turkish Journal of Rheumatology(.)Archives of Rheumatology, 28, ss.109 - 116, 2013.