Balance Impairment in Patients with Rheumatoid Arthritis and Ankylosing Spondylitis

Ali Erman Kent; Emre Gürses; Figen Karabekiroğlu; Aydan Genç

doi:10.2174/1573397119666230828162611

Balance Impairment in Patients with Rheumatoid Arthritis and Ankylosing Spondylitis

Curr Rheumatol Rev. 2023 Aug 28. doi: 10.2174/1573397119666230828162611. Online ahead of print.

Authors

Ali Erman Kent¹, Emre Gürses², Figen Karabekiroğlu³, Aydan Genç²

Affiliations

¹ Department of Audiology, Ondokuz Mayıs University, Samsun, Turkey.
² Department of Audiology, Hacettepe University Faculty of Health Sciences, Ankara, Turkey.
³ Medical School, Tokat Gaziosmanpasa University, Tokat, Turkey.

PMID: 37641997
DOI: 10.2174/1573397119666230828162611

Abstract

Background: Balance weaknesses related to mobility and fall risk in patients with rheumatic diseases are well-known. Vestibular dysfunction could negatively contribute to the balance ability of this patient population. This study aims to investigate the effects of Rheumatoid Arthritis (RA) and Ankylosing Spondylitis (AS), among the most common rheumatic diseases, on postural balance related to vestibular function.

Methods: Seventy-eight participants were grouped as RA (n=34, 43%), AS (n=24, 30.7%), and the control group consisted of healthy individuals (n=20, 25.6%). Cervical Vestibular Evoked Myogenic Potentials (cVEMP) test, which assesses the vestibular function objectively, Dizziness Handicap Inventory (DHI), which evaluates vertigo subjectively, and Berg Balance Scale (BBS) were performed.

Results: Different degrees of VEMP latency prolongations were found in the AS and RA groups. Right, and left ear N1 latencies were significantly longer in the AS group than in RA and control. Right ear P1 latency prolongation was statistically significant in the RA group. Amplitude asymmetry ratio (AAR) was found to be considerably higher in the RA and AS groups than in the control group (p<0.05). The mean BBS score in the AS group was below the fall risk score of 45. A negative statistically significant effect was observed between latency prolongation and BBS in AS groups.

Conclusion: The abnormal VEMP findings in individuals with RA and AS shows inner ear vestibular system dysfunction. This vestibular impairment strictly contributes to their postural imbalance and requires a focused vestibular rehabilitation program for balance treatment.

Keywords: ankylosing spondylitis; balance; cVEMP; rheumatoid arthritis; vestibular.