Força e equilibrio em pacientes com artrite reumatoide: uma associação com a atividade da doença
Tipo
TCC
Data de publicação
2025-06-05
Periódico
Citações (Scopus)
Autores
Furukawa, Bruna
Mikami, Clara Mayumi
Mikami, Clara Mayumi
Orientador
Skare, Thelma Larocca
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ISSN da Revista
Título de Volume
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Resumo
Introdução: A artrite reumatoide (AR) é uma doença autoimune sistêmica, inflamatória e progressiva. É caracterizada pelo acometimento simétrico das pequenas e grandes articulações, com maior envolvimento das mãos e dos pés. Diversos estudos demonstram que indivíduos com AR apresentam risco significativamente aumentado de quedas, atribuível a fatores como dor e edema articular, fraqueza muscular, alterações na marcha e no equilíbrio, instabilidade postural e redução da capacidade funcional. Objetivo: Analisar a associação entre a atividade inflamatória da AR e os comprometimentos funcionais relacionados à força muscular e ao equilíbrio postural. Métodos: Estudo observacional, transversal, caso-controle onde foram avaliados 101 pacientes com AR e 94 controles. Para mensuração da força muscular, utilizou-se o dinamômetro Jamar, aplicado para aferição da força de preensão palmar. O equilíbrio postural foi avaliado por meio da Escala de Equilíbrio de Berg (EEB). A atividade da doença foi medida pelo DAS-28 VHS (disease activity score com 28 articulações), CDAI (clinical disease activity index) e SDAI (simplified disease activity index) e foi correlacionada aos parâmetros funcionais e variáveis clínicas dos participantes. Resultados: Pacientes com AR apresentaram força de preensão palmar significativamente menor (mediana: 18 kgf) em comparação ao grupo controle (mediana: 22 kgf); p<0.0001, bem como maior comprometimento do equilíbrio postural (EEB em pacientes com AR com valores medianos de 55 e em controles com valores de 56, com p=0.0001). O risco de queda em pacientes com AR foi seis vezes superior ao dos controles. O desequilíbrio postural esteve significativamente associado ao sexo feminino, à idade do paciente e a força muscular (com p=0.04; p<0.0001 e p=0.002, respectivamente) mas não se observou associação com medidas de atividade inflamatória (todas com p= ns). Conclusão: Os resultados indicam que o prejuízo de equilíbrio em pacientes com AR está associado à fraqueza muscular, sexo feminino, idade, mas não à atividade inflamatória.
Introduction: Rheumatoid arthritis (RA) is a systemic, inflammatory and progressive autoimmune disease. It is characterized by symmetrical involvement of small and large joints, with a greater impact on the hands and feet. Several studies have demonstrated that individuals with RA present a significantly increased risk of falls, attributable to factors such as joint pain and edema, muscle weakness, gait and balance alterations, postural instability and reduced functional capacity. Objective: To analyze the association between the inflammatory activity of RA and functional impairments related to muscle strength and postural balance. Methods: Observational, cross-sectional, case-control study in which 101 patients with RA and 94 controls were evaluated. Muscle strength was measured using the Jamar dynamometer, which was used to measure handgrip strength. Postural balance was assessed using the Berg Balance Scale (BBS). Disease activity was measured by the DAS-28 ESR (disease activity score with 28 joints), CDAI (clinical disease activity index) and SDAI (simplified disease activity index) and was correlated with the functional parameters and clinical variables of the participants. Results: Patients with RA had significantly lower handgrip strength (median: 18 kgf) compared to the control group (median: 22 kgf); p<0.0001, as well as greater impairment of postural balance (BBS in patients with RA with median values of 55 and in controls with values of 56, with p=0.0001). The risk of falling in RA patients was six times higher than in controls. Postural imbalance significantly associated with female gender, patient age, and muscle strength (p=0.04; p<0.0001 and p=0.002, respectively), but no association was observed with measures of inflammatory activity (all with p=ns). Conclusion: The results indicate that balance impairment in patients with RA is associated with muscle weakness, female gender, age, but not with inflammatory activity.
Introduction: Rheumatoid arthritis (RA) is a systemic, inflammatory and progressive autoimmune disease. It is characterized by symmetrical involvement of small and large joints, with a greater impact on the hands and feet. Several studies have demonstrated that individuals with RA present a significantly increased risk of falls, attributable to factors such as joint pain and edema, muscle weakness, gait and balance alterations, postural instability and reduced functional capacity. Objective: To analyze the association between the inflammatory activity of RA and functional impairments related to muscle strength and postural balance. Methods: Observational, cross-sectional, case-control study in which 101 patients with RA and 94 controls were evaluated. Muscle strength was measured using the Jamar dynamometer, which was used to measure handgrip strength. Postural balance was assessed using the Berg Balance Scale (BBS). Disease activity was measured by the DAS-28 ESR (disease activity score with 28 joints), CDAI (clinical disease activity index) and SDAI (simplified disease activity index) and was correlated with the functional parameters and clinical variables of the participants. Results: Patients with RA had significantly lower handgrip strength (median: 18 kgf) compared to the control group (median: 22 kgf); p<0.0001, as well as greater impairment of postural balance (BBS in patients with RA with median values of 55 and in controls with values of 56, with p=0.0001). The risk of falling in RA patients was six times higher than in controls. Postural imbalance significantly associated with female gender, patient age, and muscle strength (p=0.04; p<0.0001 and p=0.002, respectively), but no association was observed with measures of inflammatory activity (all with p=ns). Conclusion: The results indicate that balance impairment in patients with RA is associated with muscle weakness, female gender, age, but not with inflammatory activity.
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Palavras-chave
artrite reumatoide , capacidade funcional , equilíbrio postural , força muscular , rheumatoid arthritis , functional capacity , postural balance , muscle strength