Evaluation of balance in patients with systemic sclerosis

BACKGROUND

The aim was to examine static/dynamic balance and proprioception of Systemic Sclerosis by comparing healthy and relationship with demographic and disease-related data.

METHODS

21 Systemic Sclerosis and 19 healthy were included.Berg Balance Scale (functional balance), Sensamove Sensbalance Maxiboard Software (static, dynamic balance:reaction time and travel time and proprioception), Scleroderma Health Assessment Questionnaire/Health Assessment Questionnaire (health status), Medsger's Disease Severity Scale, Modified Rodnan Skin Score were used in evaluation.

FINDINGS

Comparing the groups, there was significant difference in Berg Balance Scale (p:0.036); Health Assessment Questionnaire/Scleroderma Health Assessment Questionnaire (p:0.001); Static balance-center (p:0.001), front (p:0.001), back (p:0.001), left (p:0.001), right (p:0.021); proprioception-front (p:0.025);Reaction Time-front (p:0.031) and left (p:0.010);Travel Time-front (p:0.041) and left (p:0.014) in favor of healthy group.In Systemic Sclerosis, disease severity had moderate correlation with static balance-back (r:-0.504,p:0.020).Skin thickness had low correlation with Reaction Time-front (r:-0.449,p:0.041).Age had low correlation with Travel time-front (r:0.458,p:0.037) and proprioception-left (r:0.450,p:0.041); moderate with Travel time-back (r:0.515;p:0.017) and proprioception-front (r:0.539,p:0.012).

INTERPRETATION

Compared to healthy, Systemic Sclerosis had worse health status, functional balance, static/dynamic balance and proprioception.This situation is related to disease severity, skin thickness and age. Evaluations made with objective methods may have the potential to determine the extent of the problem.Clinicians can guide the treatment of patients with SSc by evaluating their static/dynamic balance and proprioception.With early treatment, additional problems that may occur due to worsening of balance and proprioception can be prevented.Proprioception and dynamic balance evaluation can be performed for older patients, static balance when disease activity is high, and dynamic balance when skin thickness score is high.

Investigation of Biopsychosocial Status, Fatigue, Sleep Quality, Alexithymia, Cognitive Functions, and Quality of Life in Behçet's Disease

Objective

The aim of this study was to compare the effects of Behçet's disease in terms of anxiety, biopsychosocial status, fatigue, sleep quality, alexithymia, cognitive level, and quality of life according to major and minor organ involvement.

Methods

The study was planned as a single-centre cohort study. Fifty patients diagnosed with Behçet's (mean age 43±11.96 years) were included in the study. The patients were divided into two groups as major organ involvement (uveitis, neuro-Behçet's, or vascular type Behçet's disease) and minor organ involvement (mucocutaneous type Behçet's disease). Biopsychosocial status was evaluated with Biopsychosocial Questionnaire (BETY-BQ), anxiety with Beck Anxiety Inventory (BAI), fatigue with Multidimensional Assessment of Fatigue (MAF) Scale, sleep quality with Pittsburgh Sleep Quality Index (PSQI), alexithymia with Toronto Alexithymia Scale-20 (TAS-20), cognition level with Mini-Mental State Examination (MMSE), and quality of life with Short Form-36 (SF-36).

Results

In the comparison according to minor and major organ involvement, there was no significant difference between the groups in BETY-BQ, BAI, MAF, PSQI, TAS-20, MMSE and SF-36 (p>0.05).

Conclusion

Behçet's disease negatively effects in parameters such as biopsychosocial status, fatigue, sleep quality, alexithymia and quality of life. The presence of major or minor organ involvement in the patients did not change these negative effects.

The validity and reliability of the Turkish version of the Brief Fear of Negative Evaluation Scale - straight forwardly in patients with systemic sclerosis

Objective

This study aimed to examine the validity and reliability of Turkish version of Brief Fear of Negative Evaluation Scale-Straightforwardly (BFNE-S (TR)) in patients with Systemic Sclerosis (SSc).

Materials and Methods

35 individuals (mean age: 53.3±13.0 years) diagnosed as SSc were included. Data on demographics, were collected via structured interview. All participants were evaluated by same investigator. The disability was evaluated with Scleroderma Health Assessment Questionnaire (SHAQ), disease severity with Medsger's Disease Severity Scale, and skin involvement with Modified Rodnan Skin Score. BFNE-S (TR) was applied to the patients with SSc who did not receive any treatment for test retest at one-week intervals.

Results

The one-factor structure was provided for all indices except Chi-Square. Factor loadings were significant. The patient responses to the BFNE-S (TR) demonstrated excellent internal consistency (Cronbach's α: 0.95). The floor effect (20%) percentage of patients who scored at floor level, was observed. Test-retest reliability of the scale was excellent with 0.91 (95%CI: 0.78-0.96). BFNE-S (TR) total score had positive correlation with SHAQ_Digestive (r=0.503) and SHAQ_Raynaud phenomenon (r=0.343)(p<0.05).

Conclusions

The BFNE-S (TR) is a reliable and valid scale and can be used for measurement of fear of negative evaluation in SSc.

POS1538-HPR INVESTIGATION OF BALANCE FUNCTIONS IN INDIVIDUALS WITH NEURO-BEHCET: A PILOT STUDY

Background

Behcet’s disease is a vasculitis, causing multisystem inflammation and resulting in oral and genital ulcers and eye and skin lesions (1). A proportion of patients also have neurological involvement, termed Neuro-behcet’s disease (2). We think about that Neuro-behçet’s disease can impact balance functions in patients due to neurological involvement. However, there is no study investigating the balance functions in patients with Neuro-behcet.

Objectives

To investigate the balance functions in individual with Neuro-behçet’s disease.

Methods

In this study 8 Neuro-behcet patients with a mean age of 38.37±16.96 who were followed in the PAU Rheumatology outpatient clinic and diagnosed by a rheumatologist according to the criteria of the International Behcet Study Group and 8 healthy control with a mean age of 42.62±13.94 with similar demographic characteristics were included. Exclusion criteria for the study were age <18 years old, having any disease which mimics BD (including systemic lupus erythematosus, vasculitis of central nervous system). Demographic data of the participants were recorded. Then, balance functions were evaluated with a balance board (Sensamove MaxiBoard, NL) in Neuro-behcet and control groups. This assesment included static balance, proprioception, and reaction. Results were analyzed with Mann Whitney U Test.

Results

Participants were similar in terms of age and gender (p>0.05). Neuro-behcet group showed a significant decrease in static balance in all directions except the right side compared to the control group (p<0.05). A significant decrease was observed in the right and left reaction times in Neuro-behcet group compared to control group (p<0.05). There was no significant difference between the two groups in proprioception assesment (p>0.05).

Conclusion

This results show that patients with Neuro-behcet may experience disturbances in static balance and reaction time. Balance and reaction exercises should be included in rehabilitation. Further research is needed on the effect of balance functions and the effectiveness of balance exercises in Neuro-behcet’s disease.

References

[1]The International Criteria for Behçet’s Disease (ICBD): a collaborative study of 27 countries on the sensitivity and specificity of the new criteria. J Eur Acad Dermatol Venereol. 2014;28(3):338-47.

[2]Borhani-Haghighi A, Kardeh B, Banerjee S, Yadollahikhales G, Safari A, Sahraian MA, ve ark. Neuro-Behcet’s disease: An update on diagnosis, differential diagnoses, and treatment. Multiple Sclerosis and Related Disorders. 2020;39:101906.

Disclosure of Interests

None declared

Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Adult-Onset Still Disease, their Relationship with Baseline Disease Activity and Subsequent Disease Course: A Single-Center Retrospective Cohort Study

Introduction: Adult-onset Still Disease (AoSD) is a rare systemic polygenic nonfamilial autoinflammatory disease of unknown aetiology. The long-term course of the disease can be categorised in three different definitions including self-limited course, intermittent course or chronic course. Recently, Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) were investigated in various rheumatic diseases as an informative markers in evaluating severity of inflammation and disease activity. Aim: To explore association between baseline NLR, PLR, disease activity score and subsequent disease course in patients with AoSD. Materials and Methods: This retrospective cohort study enrolled 61 patients with AoSD and 61 age-matched patients with Fibromyalgia Syndrome (FMS). Pouchot score was specifically used in AoSD patients to assess disease activity based on symptoms, physical examination findings and laboratory results from April 2020 to July 2020. Patients with AoSD were subgrouped into three groups: self-limited; intermittent; and chronic course. The association of NLR and PLR with disease activity score was analysed between groups by using independent samples t-test, Mann-Whitney U test and Kruskal Wallis Variance Analysis. Differences between categorical variables were analysed using chi-square test. A p≤0.05 was considered statistically significant. Results: The mean follow-up of the 61 patients with AoSD was 74 months (range, 14-169). Eighteen patients (29.5%) had a self-limited disease course, nine (14.8%) an intermittent disease course and thirty four (55.7%) a chronic disease course. AoSD patients had significantly higher serum NLR, PLR and lower Mean Platelet Volume (MPV) values than FMS patients {6.68 (1.67-19.7), 1.83 (1.1-4) p=0.0001; 187 (82.9-549), 114 (72-246) p=0.0001; 8.3 (6.4-11.3), 9.3 (7.7-11.7) p=0.0001, respectively}. NLR, PLR and Pouchot score were similar among AoSD subgroups, which were grouped according to disease pattern. The majority of patients in the self-limited and chronic course groups had higher baseline Pouchot score without statistical significance. The NLR and C-Reactive Protein (CRP) were significantly higher in AoSD patients with active disease than inactive disease {7.02 (1.8-19.7), 4.17 (1.67-14.8) p=0.06; 13 (1.9-29.5), 9 (1.6-20.9) p=0.046, respectively)}. Conclusion: High NLR and elevated CRP levels are related to active disease in AoSD patients. Although NLR, PLR and Pouchot score were similar among subgroups, patients with a chronic course or self-limited course had higher NLR values and more active disease at diagnosis compared with patients with an intermittent course.