Introduction
Methods
Participants
Baseline assessment
Follow up
Sample size
Analysis
Results
Participants
Variable | Baseline (n = 559) | 1 year follow up (n = 254) |
---|---|---|
Demographics | ||
Female n (%) | 386 (69.1) | 174 (68.5) |
Agea | 62 (12.8) | 62 (10.0) |
White British n (%) | 534 (95.5) | 240 (94.5) |
Married/living with partner n (%) | 378 (69.7) | 199 (80.6) |
Employed n (%) | 134 (24.0) | 55 (21.7) |
Disease factors | ||
Swollen joints (0–28)a | 4.6 (6.2) | 4.3 (6.0) |
Tender joints (0–28)a | 5.3 (6.9) | 5.4 (7.0) |
DAS28 score (0–10)a | 4.1 (1.6) | 4.1 (2.6) |
Taking steroids at baseline n (%) | 117 (20.9) | 47 (18.5) |
VAS pain score (0–10)a | 3.9 (2.6) | 3.8 (2.6) |
VAS fatigue score (0–10)a | 4.7 (2.8) | 4.5 (2.8) |
HAQ score (1–4)a | 2.4 (0.9) | 2.4 (0.8) |
Medical history | ||
History of fractures n (%) | 228 (40.8) | 107 (42.1) |
Poor vision (reg. Blind, v poor or poor) n (%) | 46 (8.2) | 19 (7.5) |
Number of co-morbidities a | 2.0 (2.0) | 1.9 (1.9) |
Previous surgery n (%) | 408 (73.0) | 187 (73.6) |
Previous joint replacementsa | 0.2 (0.5) | 0.2 (0.5) |
Injuries from previous falls a n (%) | 1.6 (1.4) | 1.6 (1.4) |
Fall risk factors | ||
History of stroke/Parkinsons n (%) | 38 (6.8) | 20 (7.9) |
Psychotropic medication n (%) | 104 (18.6) | 51 (20.1) |
Four or more types of medicines n (%) | 431 (77.1) | 196 (77.2) |
Feeling dizzy or unsteady n (%) | 370 (66.2) | 167 (65.7) |
Painful feet n (%) | 431 (77.2) | 192 (75.5) |
Short FES-I score (7–28)a | 15.3 (6.5) | 14.8 (6.3) |
Four test balance scale | ||
Fail at each level | ||
Unsuccessful n (%) | 39 (7.0) | 13 (5.1) |
Feet together stand n (%) | 13 (2.3) | 7 (2.8) |
Semi-tandem stand n (%) | 216 (38.6) | 93 (36.6) |
Tandem stand n (%) | 116 (20.8) | 55 (21.7) |
One leg stand n (%) | 175 (31.3) | 86 (33.9) |
Able to complete 5 chair stands n (%) | 484 (86.6) | 217 (85.4) |
Time taken for 5 chair stands (Seconds) a | 21.0 (12.2) | 21.1 (13.2) |
Occurrence of falls
Prevalence of fear-of-falling
Determinants of fear-of-falling
Disease related factors
Variable | Baseline high fear-of-falling (n = 390)b | Baseline low fear of falling (n = 168) | Follow up high fear-of-falling (n = 181) | Follow up low fear-of-falling (n = 73) |
---|---|---|---|---|
Demographics | ||||
Female (n/%) | 287 (73.6)** | 99 (58.9) | 122 (67.4) | 52 (71.2) |
Agea | 63 (12.7)** | 59.9 (12.7) | 62 (10.7)** | 62 (10.0) |
Disease factors | ||||
Swollen joints (0–28) a | 5 (6.7)** | 3 (4.7) | 5.0 (6.4)** | 2.6 (4.4) |
Tender joints (0–28) a | 6 (7.3)** | 3 (4.9) | 6 (7.2)** | 4.1 (6.3) |
DAS28 score (0–10) a | 5 (1.5)** | 3 (1.4) | 5 (1.5)** | 3 (1.6) |
Taking steroids at baseline (n/%) | 94 (24.1)* | 23 (13.7) | 42 (23.2)** | 5 (6.8) |
VAS pain score (0–10)a | 5 (2.6)** | 3 (2.2) | 4 (2.5)** | 3 (2.3) |
VAS fatigue score (0–10)a | 5 (2.6)** | 3 (2.6) | 5 (2.6)** | 3 (2.6) |
HAQ score (1–4) a | 3 (0.7)** | 2 (0.5) | 3 (0.8)** | 2 (0.6) |
Medical history | ||||
History of fractures (n/%) | 162 (41.5) | 65 (38.7) | 82 (45.3) | 25 (34.2) |
Poor vision (reg. Blind, v poor or poor) (n/%) | 37 (9.5) | 9 (5.4) | 13 (7.2) | 6 (8.2) |
Previous surgery (n/%) | 291 (74.6) | 116 (69.0) | 137 (75.7) | 50 (68.5) |
Previous joint replacements (n/%) | 99 (25.6) | 26 (15.5) | 44 (24.6) | 1 5 (15.1) |
History of injuries from previous falls (n/%) | 107 (30.7)** | 17 (11.6) | 48 (29.8)* | 8 (12.1) |
Fall risk factors | ||||
No falls in previous year (n/%) | 190 (48.7)** | 126 (75.0) | 91 (50.3)** | 54 (74.0) |
History of single fall in previous year (n/%) | 87 (22.3) | 33 (19.6) | 42 (23.2) | 13 (17.8) |
History of multiple falls in previous year (n/%) | 113 (29.0) | 9 (5.4) | 48 (26.5) | 6 (8.2) |
History of stroke/Parkinson’s (n/%) | 31 (7.9) | 7 (4.2) | 18 (9.9) | 2 (2.7) |
Psychotropic medication (n/%) | 87 (22.3)** | 17 (10.1) | 40 (22.1) | 11 (15.1) |
Four or more types of medicines (n/%) | 328 (84.1)** | 103 (61.3) | 148 (81.8)* | 48 (65.8) |
Feeling dizzy or unsteady (n/%) | 312 (80.0)** | 57 (33.9) | 136 (75.1)** | 31 (42.5) |
Painful feet (n/%) | 321 (82.5)** | 109 (64.9) | 143 (79.4) | 48 (65.8) |
Four test balance scale (n/%) | ||||
Fail at each level | ||||
Unsuccessful | 39 (10.0)** | 0 (0.0) | 13 (7.2)** | 0 (0.0) |
Feet together stand | 13 (3.3) | 0 (0.0)* | 6 (3.3) | 1 (1.4) |
Semi-tandem stand | 177 (45.4) | 39 (23.2)* | 75 (41.4) | 18 (24.7) |
Tandem stand | 81 (20.8) | 34 (20.2)* | 41 (22.7) | 14 (19.2) |
One leg stand | 80 (20.5) | 95 (56.6)* | 46 (25.4) | 40 (54.8) |
Able to complete 5 chair stands (n/%) | 316 (81.0)** | 167 (99.4) | 145 (80.1)** | 72 (98.6) |
Predictors of fear-of-falling
Risk factor | Score | Odds ratio (OR) | OR 95% Confidence Intervals | p-value |
---|---|---|---|---|
Gender | Male (referent) Female | 1.24 | 0.64,2.37 | 0.65 |
Age | 18–88 | 0.97 | 0.95,1.00 | 0.1 |
Number of swollen joints | 0–28 | 0.91 | 0.85,0.99 | 0.02 |
Number of tender joints | 0–28 | 0.97 | 0.89,1.04 | 0.4 |
DAS28 Score | 0.1–8.9 | 1.37 | 0.95,1.99 | 0.1 |
Psychotropic medicines | No (referent) | 1.15 | 0.44,3.00 | 0.8 |
Yes | ||||
Four or more types of medicines | No (referent) | 1.74 | 0.82,3.68 | 0.1 |
Yes | ||||
Taking steroids at baseline | No (referent) | 1.33 | 0.58,3.03 | 0.5 |
Yes | ||||
History of stroke or Parkinson’s disease | No (referent) | 0.53 | 0.14,1.92 | 0.3 |
Yes | ||||
VAS pain score | 0–10 | 1.00 | 0.85,1.16 | 0.9 |
VAS fatigue score | 0–10 | 1.03 | 0.90,1.17 | 0.7 |
History of falls in previous 12 months | 0 fall (referent) 1 fall 2 or more falls | 1.56 5.43 | 0.70,3.52 1.81,16.27 | 0.3 0.003 |
Number of joint replacement | 0–6 | 0.87 | 0.57,1.33 | 0.5 |
History of previous injuries | No (referent) | 1.11 | 0.48,2.57 | 0.8 |
Yes | ||||
History of previous surgery | No (referent) | 0.66 | 0.33,1.30 | 0.2 |
Yes | ||||
Painful feet | No (referent) | 2.34 | 1.11,4.52 | 0.025 |
Yes | ||||
HAQ score | 1.00–4.00 | 7.79 | 3.87,15.69 | < 0.001 |
Four test balance scalea: | ||||
Semi- tandem stand | 2 | 1.15 | 0.50,2.64 | 0.7 |
Tandem stand | 3 | 0.71 | 0.30,1.67 | 0.4 |
One – leg stand | 4 (referent) | |||
Complaints of feeling dizzy or unsteady | No (referent) | 3.81 | 2.01,7.22 | < 0.001 |
Yes | ||||
Time taken for chair stand test | 4–104 s | 1.05 | 1.00, 1.10 | 0.048 |
Risk factor | Score | Odds ratio (OR) | OR 95% Confidence Intervals | p-value |
---|---|---|---|---|
Gender | Male (referent) | 0.21 | 0.07, 0.63 | 0.05 |
Female | ||||
Age | 18–88 | 0.95 | 0.89,1.00 | 0.06 |
Number of swollen joints | 0–28 | 0.99 | 0.86, 1.13 | 0.8 |
Number of tender joints | 0–28 | 0.92 | 0.82,1.03 | 0.1 |
DAS28 Score | 0.1–8.9 | 1.31 | 0.70,2.44 | 0.4 |
Psychotropic medicines | No (referent) | 1.11 | 0.31,4.00 | 0.9 |
Yes | ||||
Four or more types of medicines | No (referent) | 0.81 | 0.26,2.52 | 0.7 |
Yes | ||||
Taking steroids at baseline | No (referent) | 3.60 | 0.82,15.74 | 0.09 |
Yes | ||||
History of stroke or Parkinson’s disease | No (referent) | 1.30 | 0.16,10.47 | 0.8 |
Yes | ||||
VAS pain score | 0–10 | 0.96 | 0.75,1.22 | 0.7 |
VAS fatigue score | 0–10 | 1.19 | 0.96,1.46 | 0.1 |
History of falls in previous 12 months | 0 fall (referent) 1 fall 2 or more falls | 2.44 6.08 | 0.68,8.71 1.19,30.99 | 0.2 0.03 |
Number of joint replacements | 0–6 | 0.83 | 0.23,3.04 | 0.8 |
History of injuries from previous falls | No (referent) | 0.81 | 0.22,2.95 | 0.8 |
Yes | ||||
History of previous surgery | No (referent) | 1.15 | 0.41,3.28 | 0.8 |
Yes | ||||
Painful feet | No (referent) | 0.92 | 0.32,2.64 | 0.8 |
Yes | ||||
HAQ score | 1.00–4.00 | 4.87 | 1.59,14.92 | 0.006 |
Four test balance scalea: | ||||
Semi- tandem stand | 2 | 0.81 | 0.24,2.69 | 0.7 |
Tandem stand | 3 | 1.40 | 0.37,5.40 | 0.6 |
One – leg stand | 4 (referent) | |||
Complaints of feeling dizzy or unsteady | No (referent) | 1.67 | 0.65,4.27 | 0.29 |
Yes | ||||
Time taken for chair stand test | 4–104 s | 1.11 | 1.01, 1.20 | 0.02 |
Baseline fear-of-falling | Low (referent) | 30.05 | 1.42,637.18 | 0.03 |
High |