Falls and their association with physical tests, functional capacity, clinical and demographic factors in patients with rheumatoid arthritis.

OBJECTIVE: To evaluate the occurrence of falls reported by rheumatoid arthritis patients and its relation to disease activity, functional capacity and physical fitness. MATERIALS AND METHODS: A cross-sectional study constituted by a sample of 97 rheumatoid arthritis patients from the city of Marília (SP) from 2012 to 2013, were assessed for disease activity. Instruments validated for Brazilian population in order to evaluate physical and functional capacity were used. Data analysis was carried out with descriptive statistics, Spearman correlation and Chi-squared test, considering p<0.05. RESULTS: 88.7% were female subjects with a mean age of 56 (±11.7) years. The median duration of rheumatoid arthritis was 10 years (P25=6 and P75=17) and the mean of disease activity was 3.6 (±1.3), what was considered a moderate activity. In the last 12 months 37.1% of patients experienced at least one fall, with a total of 52 episodes, and fear of falling was reported by 74.2% of them, but this was not associated to the occurrence of a fall (χ2=1.19, p=0.27). Gender, number of medications, age, disease activity, duration of rheumatoid arthritis, functional capacity, and physical tests showed no associations with history of falls in the past year. CONCLUSION: It was observed that the occurrence of falls and the fear of falling are quite common in this population. The occurrence of falls in this sample of rheumatoid arthritis patients bears no relation to disease activity, functional capacity, or physical fitness tests.

[Quality of life in adults and elderly patients with rheumatoid arthritis]. / Qualidade de vida de pacientes adultos e idosos com artrite reumatoide.

OBJECTIVE: To analyze and compare quality of life (QoL) in adults and elderly patients with rheumatoid arthritis (RA). METHODS: This was a cross-sectional quantitative study. The tools include the Medical Outcomes Study Short Form-36 (SF-36), the Disease Activity Score 28 (DAS-28), the Assessment Health Questionnaire (HAQ), the Beck Depression Inventory (BDI) and the 6-Minute Walk Test (6MWT). Data analysis was done by descriptive statistics, Student's t test and linear regression test, with significance level of p <0.05. RESULTS: The sample consisted of 99 patients diagnosed with RA, divided into adults and elderly. Those considered adults were 18-59 years-old and those with 60 years or older where considered elderly. In SF-36, the groups showed the pain domain as the most compromised and the emotional aspects domain as the less compromised. Both showed moderate level of disease activity and mild disability. Applying the t test, it was found that there was no significant difference between groups with respect to QoL, functional ability, depression and disease activity. The difference was significant in the 6MWT, in which the elderly achieved an average of 330.8 m, and the adults, 412.2 m (p=0.000). In linear regression, a significant correlation (r=-0.31) between the 6MWT and increasing age was noted. CONCLUSION: QoL and functional capacity in RA were affected in adults and the elderly. How-ever, the results showed no significant difference between groups, with the exception of the 6MWT.

Falls and their association with physical tests, functional capacity, clinical and demographic factors in patients with rheumatoid arthritis / Ocorrência de quedas e sua associação com testes físicos, capacidade funcional e aspectos clínicos e demográficos em pacientes com artrite reumatoide

ABSTRACT Objective: To evaluate the occurrence of falls reported by rheumatoid arthritis patients and its relation to disease activity, functional capacity and physical fitness. Materials and methods: A cross-sectional study constituted by a sample of 97 rheumatoid arthritis patients from the city of Marília (SP) from 2012 to 2013, were assessed for disease activity. Instruments validated for Brazilian population in order to evaluate physical and functional capacity were used. Data analysis was carried out with descriptive statistics, Spearman correlation and Chi-squared test, considering p < 0.05. Results: 88.7% were female subjects with a mean age of 56 (±11.7) years. The median duration of rheumatoid arthritis was 10 years (P25 = 6 and P75 = 17) and the mean of disease activity was 3.6 (±1.3), what was considered a moderate activity. In the last 12 months 37.1% of patients experienced at least one fall, with a total of 52 episodes, and fear of falling was reported by 74.2% of them, but this was not associated to the occurrence of a fall (χ 2 = 1.19, p = 0.27). Gender, number of medications, age, disease activity, duration of rheumatoid arthritis, functional capacity, and physical tests showed no associations with history of falls in the past year. Conclusion: It was observed that the occurrence of falls and the fear of falling are quite common in this population. The occurrence of falls in this sample of rheumatoid arthritis patients bears no relation to disease activity, functional capacity, or physical fitness tests.

RESUMO Objetivo: Avaliar a ocorrência de quedas reportadas por pacientes com artrite reumatoide (AR) e sua associação com a atividade da doença, capacidade funcional e aptidão física. Material e métodos: Estudo transversal com uma amostra de 97 pacientes com AR em Marília (SP), entre 2012 e 2013. Foram usados instrumentos validados na população brasileira para avaliar capacidade física e funcional. Análise dos dados com estatística descritiva, correlações de Spearman e qui-quadrado, considerado p < 0,05. Resultados: Dos pacientes, 88% eram mulheres, média de 56, anos (± 11,7), duração mediana da AR de 10 anos (P25 = 6 e P75 = 17) e média da atividade da doença 3,6 (± 1,3). Nos últimos 12 meses, 37,1% tiveram pelo menos uma queda (total 52 episódios), 74,2% relataram medo de cair, porém sem associação com a ocorrência de quedas (χ2 = 1,19, p = 0,27). Sexo, quantidade de medicamentos, idade, atividade da doença, duração da AR, capacidade funcional e testes físicos não estão associados com história de queda no último ano. Conclusões: Observou-se que a ocorrência de quedas e o medo de cair é frequente nessa população. A ocorrência de quedas nessa amostra de pacientes com AR não está relacionada à atividade da doença, à capacidade funcional e a testes de aptidão física.

Correlação entre instrumentos de avaliação da funcionalidade e equilíbrio em pacientes com artrite reumatoide / Correlation among functionality and balance assessment instruments in rheumatoid arthrits patients

A artrite reumatoide (AR) é uma doença autoimune inflamatória sistêmica, crônica e progressiva, que pode causar diminuição da mobilidade, força e atividade física, levando a alterações de propriocepção, equilíbrio postural e marcha, que aumentam o risco de queda nesses pacientes. O presente estudo teve como objetivo verificar se existe correlação entre testes de funcionalidade e equilíbrio em pacientes com AR. Para isso foi feito um corte transversal com a amostra composta por 99 pacientes com diagnóstico de AR de ambos os sexos. Os instrumentos de avaliação do risco de queda usados foram: Escala de Equilíbrio de Berg (Berg), Teste "Timed Up and Go" (TUG), Teste de Caminhada de 6 Minutos e Short Physical Performance Battery (SPPB) ou Bateria de Testes de Guralnik. Feito teste de Kolmogorov-Smirnov para normalidade de distribuição e correlação de Spearman, com nível de significância de p < 0,05. Os pacientes eram 88,9% do sexo feminino e com idade média de 56,15 anos (± 11,64). A idade apresentou correlação fraca, porém significativa de modo que quanto mais velho, pior o desempenho nos testes. O desempenho médio nos instrumentos não colocou esses pacientes com AR como alto risco de queda, porém não há valores de corte específicos para essa população. Os instrumentos mostraram correlação de moderada a forte entre si (p < 0,01). Conclui-se, portanto, que os testes físicos realizados são correlacionados e representam bem a capacidade física desses pacientes com AR,principalmente entre pessoas a partir dos 41 anos e homens.

Rheumatoid arthritis (RA) is a systemic inflammatory autoimmune disease, chronic and progressive, which can cause pain, decreased mobility, physical strength and activity, leading to changes in proprioception, postural balance and gait, which increase the risk of falls in these patients. The present study aimed to verify if there´s correlation among functionality and balance tests in RA patients. This study was conducted with a cross-section sample of 99 patients diagnosed with RA of both sexes. Assessment instruments fall risk were used: Berg Balance Scale (BBS), Test "Timed Up and Go" (TUG), 6 Minutes Walking Test (6MWT) and Short Physical Performance Battery (SPPB) or Guralnik Battery Test. Made Kolmogorov-Smirnov test for normality of distribution and Spearman correlation, with significance level of p < 0.05. Patients were 88,9% female with a mean age of 56.15 years (± 11.64). Age showed a weak correlation, but significant o that the older, worse performance on tests. The average performance of the instruments do not put these RA patients as high risk of falling, but there is no specific cut off values for this population. The instruments showed moderate to strong correlation with each other (p < 0.01). We conclude, therefore, that the physical tests are performed and correlated well represent the physical capacity of RA patients, especially among people over 41 years old and men.

Qualidade de vida de pacientes adultos e idosos com artrite reumatoide / Quality of life in adults and elderly patients with rheumatoid arthritis

Objetivo: Analisar e comparar a qualidade de vida (QV) de pacientes adultos e idosos com artrite reumatoide (AR). Métodos: Trata-se de um estudo transversal, quantitativo. Os instrumentos aplicados incluem o Medical Outcomes Study-36 Short Form (SF-36), o Disease Activity Score 28 (DAS-28), o Health Assestment Questionnaire (HAQ), o inventário de depressão de Beck e o Teste de Caminhada de 6 Minutos (TC6). A análise dos dados foi feita por estatística descritiva, teste t de student e teste de regressão linear, sendo adotado nível de significância de p<0,05. Resultados: A amostra foi constituída por 99 pacientes com diagnóstico de AR, divididos em adultos e idosos. Foram considerados adultos aqueles de 18 a 59 anos, e idosos aqueles com 60 anos ou mais. No SF-36 os grupos apresentaram o domínio dor como o mais comprometido e o domínio aspectos emocionais como menos comprometido. Ambos apresentaram nível moderado de atividade da doença e deficiência leve. Aplicando-se o teste t, constatou-se que não há diferença significativa entre os grupos no que diz respeito à QV, capacidade funcional, depressão e atividade da doença. A diferença foi significativa no TC6, no qual os idosos obtiveram uma média de 330,8 m, e os adultos 412,2m, com um p=0,000. Na regressão linear houve correlação significativa (r=-0,31) entre a distância percorrida no TC6 e o aumento da idade. Conclusão: A QV e a capacidade funcional na AR mostrou-se afetada nos adultos e nos idosos; porém, os resultados mostraram que não há diferença entre os grupos com exceção do TC6. .

Objective: To analyze and compare quality of life (QoL) in adults and elderly patients with rheumatoid arthritis (RA). Methods: This was a cross-sectional quantitative study. The tools include the Medical Outcomes Study Short Form-36 (SF-36), the Disease Activity Score 28 (DAS-28), the Assessment Health Questionnaire (HAQ), the Beck Depression Inventory (BDI) and the 6-Minute Walk Test (6MWT). Data analysis was done by descriptive statistics, Student's t test and linear regression test, with significance level of p <0.05. Results: The sample consisted of 99 patients diagnosed with RA, divided into adults and elderly. Those considered adults were 18-59 years-old and those with 60 years or older where considered elderly. In SF-36, the groups showed the pain domain as the most compromised and the emotional aspects domain as the less compromised. Both showed moderate level of disease activity and mild disability. Applying the t test, it was found that there was no significant difference between groups with respect to QoL, functional ability, depression and disease activity. The difference was significant in the 6MWT, in which the elderly achieved an average of 330.8 m, and the adults, 412.2 m (p=0.000). In linear regression, a significant correlation (r=-0.31) between the 6MWT and increasing age was noted. Conclusion: QoL and functional capacity in RA were affected in adults and the elderly. However, the results showed no significant difference between groups, with the exception of the 6MWT. .