Cervical proprioceptive impairment in patients with rheumatoid arthritis
- 49 Downloads
Rheumatoid arthritis (RA) involving the cervical spine can lead to various neurologic defects and impairment of proprioception is just one of them. The aim of this study was the assessment of cervical proprioception and its relation with radiographic, clinical, and functional characteristics of patients with RA. One hundred and six rheumatoid arthritis patients who diagnosed according to the 2010 American College of Rheumatology/European League Against Rheumatism criteria and age, gender, educational status matched one hundred and six healthy volunteers were enrolled in this study. Cervical joint position error test (CJPET) was applied to healthy volunteers and RA patients for cervical proprioception assessment. Fatigue, depression, balance, quality of life and balance scales were administered to all patients. Cervical radiography was used to assess cervical subluxations. Regression analysis was used for grading the factors which had relations with cervical proprioception. Mean age of patients and healthy volunteers was 51 ± 11.1 and 48.9 ± 9.2, respectively. Scores of CJPET were statistically significantly higher in RA group than healthy volunteers (p = 0.001). CJPET scores were negatively correlated with Berg balance scale findings in right rotation, left rotation, flexion and extension (rho = − 0.421,− 0.473,− 0.448,− 0.515). There was weak or not significant correlation between the scores of CJPET and fatigue, depression, and quality of life scales. Scores of CJPET in patients with atlantoaxial subluxations (AAS) were statistically significantly higher than those without AAS (p < 0.05). Regression analysis results showed that the AAS was related to impaired cervical proprioception on right and left rotations. There was no correlation between CJPET scores and functional parameters. Cervical proprioception impaired in RA patients. This impairment was related to the existence of AAS and balance problems.
KeywordsRheumatoid arthritis Cervical proprioception Proprioception Atlantoaxial subluxation Balance
The proofreading of the present study was performed by proof-reading-service.com, Hertfordshire, United Kingdom.
FU: Designing the study, collecting, analyzing the data, writing the manuscript; CU: Analyzing the data, writing the manuscript; MTD: Designing the study, analyzing the data and coordinating the study. All co-authors of the study take full responsibility for the integrity of the final version of the manuscript.
This research received no specific grant from any funding agency in the public, commercial, or not-for profit sectors.
Compliance with ethical standards
Conflict of interest:
All authors declare that there is no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (Marmara University School of Medicine Ethical Committee with a reference number of 09.2016.013) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 5.Collins DN, Barnes CL, FitzRandolph RL (1991) Cervical spine instability in rheumatoid patients having total hip or knee arthroplasty. Clin Orthop Relat Res 272:127–135Google Scholar
- 13.Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO III, Birnbaum NS, Burmester GR, Bykerk VP, Cohen MD (2010) 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum 62(9):2569–2581CrossRefGoogle Scholar
- 21.Piper BF, Lindsey AM, Dodd MJ, Ferketich S, Paul SM, Weller S (1989) The development of an instrument to measure the subjective dimension of fatigue. In: Funk SG, Tornquist EM, Champagne MT, Archer Gropp LM, Wiese RA (eds) Key aspects of comfort: management of pain, fatigue and nausea. Springer, New York, pp 199–208CrossRefGoogle Scholar
- 29.Hisli N (1989) Beck depresyon envanterinin universite ogrencileri icin gecerliligi, guvenilirligi. Turk Psikoloji Dergisi 7(23):3–13Google Scholar
- 30.Kocyigit H (1999) Reliability and validity of the Turkish version of short form-36 (SF-36): a study in a group of patients will rheumatic diseases. Ilac ve Tedavi Dergisi 12:102–106Google Scholar
- 33.Cohen RJ, Swerdlik ME, Sturman ED (2013) Psychological testing and assessment: an introduction to tests and measurement. McGraw Hill, New YorkGoogle Scholar