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Foot and ankle characteristics associated with falls in adults with established rheumatoid arthritis: a cross-sectional study

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posted on 2022-12-19, 23:19 authored by A Brenton-Rule, N Dalbeth, Hylton MenzHylton Menz, S Bassett, K Rome
Background: People with rheumatoid arthritis (RA) have an increased risk of falls. The foot is a common site of pathology in RA and foot problems are reported in up to 90 % of patients with established disease. The aim of this study was to determine whether foot and ankle characteristics are associated with falls in people with RA. Methods: Adults with RA were recruited from rheumatology outpatient clinics in Auckland, New Zealand. Participants reported whether they had fallen in the preceding year, and the number of falls. Clinical characteristics, common fall risk factors, and foot and ankle variables were measured. Univariate parametric and non-parametric analysis compared fallers and non-fallers on all variables to determine significant differences. Logistic regression analysis identified variables independently associated with falls. Results: Two hundred and one participants were prospectively recruited. At least one fall in the preceding 12-months was reported by 119 (59 %) participants. Univariate analysis showed that fallers had significantly longer mean disease duration, more co-morbid conditions, an increase in lower limb tender joints, higher midfoot peak plantar pressures and were more likely to have a history of vascular disease than non-fallers. Fallers also reported greater difficulty with activities of daily living, increased fear of falling and greater self-reported foot impairment. Logistic regression analysis revealed that increased midfoot peak plantar pressures (odds ratio (OR) 1.12 [for each 20 kPa increase], 95 % confidence interval (CI) 1.00-1.25), self-reported foot impairment (OR 1.17 [for each three point increase], 95 % CI 1.05-1.31) and history of vascular disease (OR 3.22, 95 % CI 1.17-8.88) were independently associated with a fall in the preceding 12 months. Conclusions: Elevated midfoot peak plantar pressures, self-reported foot impairment and vascular disease are associated with falls in people with RA. Assessment of foot deformity, foot function and self-reported foot impairment may be of benefit when considering falls prevention strategies in people with RA. Trial registration: Australia New Zealand Clinical Trial Registry (trial ACTRN12612000597897).


Angela Brenton-Rule's work is funded by Arthritis New Zealand and the Health Research Council of New Zealand. Neither organisation had any role in the study design, data collection, data analysis, interpretation of data, writing of the manuscript or decision to submit the manuscript for publication. HBM is currently a National Health and Medical Research Council of Australia Senior Research Fellow (ID: 1020925).


Publication Date



BMC Musculoskeletal Disorders





Article Number



8p. (p. 1-8)


BioMed Central



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© 2016 Brenton-Rule et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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