Patrick J Knox1, Peter C Coyle1, Jenifer M Pugliese1, Ryan T Pohlig2,3, Jaclyn M Sions1, Gregory E Hicks4. 1. Department of Physical Therapy, University of Delaware, 540 S. College Ave, Newark, DE, 19713, USA. 2. Department of Epidemiology, University of Delaware, Newark, DE, USA. 3. Biostatistics Core, University of Delaware, Newark, DE, USA. 4. Department of Physical Therapy, University of Delaware, 540 S. College Ave, Newark, DE, 19713, USA. ghicks@udel.edu.
Abstract
BACKGROUND: Older adults with concurrent low back and hip pain are predisposed to reductions in physical performance and health-related quality of life. Yet no study to date has assessed whether or not coexisting hip impairments increase fall risk in older adults with chronic low back pain (CLBP). The objective of this study was to determine if hip osteoarthritis (OA) signs and symptoms per American College of Rheumatology (ACR) criteria are associated with fall risk over a 1-year span. METHODS: Falls were prospectively monitored for 1 year via fall calendars. Age, sex, body mass index (BMI), anxiolytic use, balance confidence, LBP-related disability, and prior fall history were identified as covariates. Hip pain, pain with hip internal rotation (IR), hip IR range of motion (ROM) ≥ 15°, and morning stiffness lasting ≤ 60 min were evaluated at baseline and summed to represent hip OA impairment burden. A generalized linear model with a Poisson distribution and log link function assessed the association between ACR criteria and fall risk beyond established covariates. As a secondary analysis, binary logistic regression assessed ACR criteria and the odds of falling two or more times within a year. RESULTS: Data from two-hundred and ten participants were analyzed. Hip OA signs and symptoms were present in 97.1% of the participants, and hip OA impairment burden was significantly greater (p < 0.050) in participants who fell ≥ 2 times compared to single and non-fallers. Higher hip OA impairment burden was associated with significantly increased fall risk (p = 0.001, risk ratio = 1.23, 95% CI 1.09-1.38) and odds of falling multiple times (p < 0.05, odds ratio = 1.41, 95% CI 1.01-1.95) after adjustment for covariates. CONCLUSIONS: Older adults with CLBP and concomitant hip impairments are an at-risk group for falling. Healthcare professionals should employ falls screening and preventive measures to avoid negative sequelae in this vulnerable population.
BACKGROUND: Older adults with concurrent low back and hip pain are predisposed to reductions in physical performance and health-related quality of life. Yet no study to date has assessed whether or not coexisting hip impairments increase fall risk in older adults with chronic low back pain (CLBP). The objective of this study was to determine if hip osteoarthritis (OA) signs and symptoms per American College of Rheumatology (ACR) criteria are associated with fall risk over a 1-year span. METHODS: Falls were prospectively monitored for 1 year via fall calendars. Age, sex, body mass index (BMI), anxiolytic use, balance confidence, LBP-related disability, and prior fall history were identified as covariates. Hip pain, pain with hip internal rotation (IR), hipIR range of motion (ROM) ≥ 15°, and morning stiffness lasting ≤ 60 min were evaluated at baseline and summed to represent hip OA impairment burden. A generalized linear model with a Poisson distribution and log link function assessed the association between ACR criteria and fall risk beyond established covariates. As a secondary analysis, binary logistic regression assessed ACR criteria and the odds of falling two or more times within a year. RESULTS: Data from two-hundred and ten participants were analyzed. Hip OA signs and symptoms were present in 97.1% of the participants, and hip OA impairment burden was significantly greater (p < 0.050) in participants who fell ≥ 2 times compared to single and non-fallers. Higher hip OA impairment burden was associated with significantly increased fall risk (p = 0.001, risk ratio = 1.23, 95% CI 1.09-1.38) and odds of falling multiple times (p < 0.05, odds ratio = 1.41, 95% CI 1.01-1.95) after adjustment for covariates. CONCLUSIONS: Older adults with CLBP and concomitant hip impairments are an at-risk group for falling. Healthcare professionals should employ falls screening and preventive measures to avoid negative sequelae in this vulnerable population.
Entities:
Keywords:
Accidental falls; Aged; Low back pain; Osteoarthritis; Risk factors
Authors: Richard A Deyo; Samuel F Dworkin; Dagmar Amtmann; Gunnar Andersson; David Borenstein; Eugene Carragee; John Carrino; Roger Chou; Karon Cook; Anthony DeLitto; Christine Goertz; Partap Khalsa; John Loeser; Sean Mackey; James Panagis; James Rainville; Tor Tosteson; Dennis Turk; Michael Von Korff; Debra K Weiner Journal: J Pain Date: 2014-04-29 Impact factor: 5.820
Authors: Marian T Hannan; Margaret M Gagnon; Jasneet Aneja; Richard N Jones; L Adrienne Cupples; Lewis A Lipsitz; Elizabeth J Samelson; Suzanne G Leveille; Douglas P Kiel Journal: Am J Epidemiol Date: 2010-04-01 Impact factor: 4.897
Authors: Tatjana Paeck; Manuela L Ferreira; Clive Sun; Chung-Wei Christine Lin; Anne Tiedemann; Chris G Maher Journal: Arthritis Care Res (Hoboken) Date: 2014-08 Impact factor: 4.794
Authors: Sean D Rundell; Adam P Goode; Pradeep Suri; Patrick J Heagerty; Bryan A Comstock; Janna L Friedly; Laura S Gold; Zoya Bauer; Andrew L Avins; Srdjan S Nedeljkovic; David R Nerenz; Larry Kessler; Jeffrey G Jarvik Journal: Arch Phys Med Rehabil Date: 2016-08-09 Impact factor: 3.966