AB0795 Are patients with ankylosing spondylitis afraid of falling compared to healthy controls?: the role of balance and posture

Abstract

BackgroundFear of falling is a low perception of self-efficacy in avoiding falling during basic, non-hazardous activities of daily life, and concern about falling. It is a risk factor for falls and individuals without a history of falls may have fear of falling. Although it has been shown that the risk of falls is increased in patients with ankylosing spondylitis (AS), there is a lack of sufficient data on the fear of falling in AS patients and the relation of falls with spinal mobility and balance in these patients is controversial.ObjectivesThe aims of this study were to compare the fear of falling and balance parameters of AS patients with healthy controls and to evaluate the relation of fear of falling with spinal mobility, balance parameters, pain, disease activity, and functional capacity in patients with AS.MethodsForty patients diagnosed with AS and 50 gender-age matched healthy controls were included. Demographic data and the number of falls within the last one year were questioned for all participants. Fear of falling by Falls Efficacy Scale-International (FES-I), balance with the Berg Balance Scale (BBS) and Short Physical Performance Battery (SPPB) were assessed in all participants. In patients; spinal mobility by Bath AS Metrology Index (BASMI), pain by visual analog scale (VAS), disease activity by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), functional capacity by Bath Ankylosing Spondylitis Functional Index (BASFI) were evaluated. Kolmogorov Smirnov test, chi-square test, Student t test, Pearson correlation analysis, and Multivariate linear regression analysis were used for statistical analyses.ResultsThe mean ages of the patient and control groups were 45.73 ± 9.5 (18-63) and 42.28 ± 8.1 (26-56), respectively. Patients’ fear of falling scores were significantly higher, and BBS and SPPB scores were significantly lower compared to the controls (p<0.001). In the patients FES-I scores were positively correlated with VAS pain, BASFI and BASDAI scores, and negatively correlated with BBS and SPPB scores (SPPB p<0.05, others p<0.001). BASMI scores were only correlated with BBS scores negatively (p<0.05). In the regression analysis, positive correlation with FES-I was BASFI scores (p<0.05).ConclusionIn this study, patients with AS had more fear of falling than healthy individuals. Patients’ balance parameters were worse than controls and fear of falling was associated with poor balance in AS patients. Functional limitation, increased pain and disease activity were also associated with fear of falling in AS patients. Since AS sample in this study had a good mobility, no correlation might not have been found between fear of falling and spinal mobility. According the results of this study AS patients may have fear of falling even if there is no history of falls; and balance exercises, reducing disease activity, preserving functions may help to reduce fear of falling in these patients. Future studies including patients with mobility restriction may clarify the relationship between fear of falling and mobility in AS patients.