Title:Balance Impairment in Patients with Rheumatoid Arthritis and
Ankylosing Spondylitis
Volume: 20
Issue: 4
Author(s): Ali Erman Kent*, Emre Gürses, Figen Karabekiroğlu and Aydan Genç
Affiliation:
- Department of Audiology, Ondokuz Mayıs University, Samsun, Turkey
Keywords:
Rheumatoid arthritis, ankylosing spondylitis, balance, vestibular, cVEMP, vestibular dysfunction.
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.
