Balance Impairment in Patients with Rheumatoid Arthritis and Ankylosing Spondylitis
This study aims to investigate the effects of the most common rheumatic diseases on postural balance related to vestibular function. Seventy-eight participants grouped as Rheumatoid Arthritis (RA) (n=34, 43%), Ankylosing Spondylitis (AS) (n=24, 30.7%), and the control group consisted of healthy individuals (n=20, 25.6%). The cervical Vestibular Evoked Myogenic Potentials (cVEMP) test, Dizziness Handicap Inventory (DHI), and Berg Balance Scale (BBS) was applied to all three groups. The results were compared.
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The cases of this study were evaluated at Samsun Ondokuz Mayıs University, Department of Audiology. It was carried out in cooperation with Samsun Ondokuz Mayıs University Faculty of Medicine Hospital, Department of Physical Medicine and Rehabilitation, Rheumatology Polyclinic. Seventy-eight participants aged 20-65 years were included. Rheumatoid arthritis (RA), Ankylosing spondylitis (AS), and control groups consisted of 34, 24, and 20 participants, respectively. Diagnostic criteria were accepted based on positive Rheumatoid Factor (RF) and a total score of ≥6 by the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) for RA. For the AS, positive HLA-B27 and sacroiliitis diagnosis by Modified New York Criteria. Volunteers with other concomitant rheumatic, systemic or metabolic diseases were excluded. The age, sex, and disease duration of the patients in the study groups were questioned. The cervical Vestibular Evoked Myogenic Potentials (cVEMP) Test, Dizziness Handicap Inventory (DHI) questionnaire, and Berg Balance Scale (BBS) was applied to all three groups. The presence of conductive hearing loss (CHL), which affects the latency and amplitudes of cVEMP waves, was examined following otolaryngology examination by air and bone conduction audiometric tests in all individuals. The otolaryngology examination results of the individuals were normal, and individuals with existing CHL were excluded. cVEMP response was obtained in all individuals in the control group. However, 2 (5.88%) of 34 individuals in the RA group and 1 (4.16%) of 24 individuals in the AS group didn't have cVEMP responses. For this reason, comparisons of cVEMP test results, BBS, and DHI scores were analyzed on 32 individuals from the RA group, 23 individuals from the AS group, and 20 individuals from the control group.