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Objective To identify the clinical and biomechanical characteristics associated with falls in people with RA. Methods A total of 436 people ≥60 years of age with RA completed a 1 year prospective survey of falls in the UK. At baseline, questionnaires recorded data including personal and medical history, pain and fatigue scores, health-related quality of life (HRQoL), physical activity and medication history. The occurrence of falls wasmonitored prospectively over 12 months by monthly self-reporting. A nested sample of 30 fallers (defined as the report of one or more falls in 12 months) and 30 non-fallers was evaluated to assess joint range of motion (ROM), muscle strength and gait parameters. Multivariate regression analyses were undertaken to determine variables associated with falling. Results Compared with non-fallers (n  = 236), fallers (n  = 200) were older (P  = 0.05), less likely to be married (P  = 0.03), had higher pain scores (P  < 0.01), experienced more frequent dizziness (P  < 0.01), were frequently taking psychotropic medications (P  = 0.02) and reported lower HRQoL (P  = 0.02). Among those who underwent gait laboratory assessments, compared with non-fallers, fallers showed a greater anteroposterior (AP; P  = 0.03) and medial-lateral (ML) sway range (P  = 0.02) and reduced isokinetic peak torque and isometric strength at 60° knee flexion (P  = 0.03). Fallers also showed shorter stride length (P  = 0.04), shorter double support time (P  = 0.04) and reduced percentage time in swing phase (P  = 0.02) and in knee range of motion through the gait cycle (P  < 0.01). Conclusion People with RA have distinct clinical and biomechanical characteristics that place them at increased risk of falling. Assessment for these factors may be important to offer more targeted rehabilitation interventions. [ABSTRACT FROM AUTHOR]

This study investigated the feasibility of the uncontrolled manifold approach (UCM) to analyse gait data variability in relation to the control of the centre of mass (COM) in adults with and without neuropathology. The proposed method was applied to six able-bodied subjects to characterise mechanisms of normal postural control during stance phase. This approach was repeated on an early stroke patient, who attended the laboratory three times at three monthly intervals, to characterise the variability of COM movement during walking with and without an orthosis. Both able-bodied subjects and the stroke participant controlled COM movement during stance but utilized a different combination of lower limb joint kinematics to ensure that the COM trajectory was not compromised. Interestingly, the stroke subject, despite a higher variability in joint kinematics, was able to maintain a stable COM position throughout stance phase. The stabilisation of the COM decreased when the patient walked unaided without the prescribed orthosis but increased over the six months of study. The UCM analysis demonstrated how a stroke patient used a range of lower limb motion pattern to stabilise the COM trajectory. It is suggested that this analysis can be used to track changes in these movement patterns in response to rehabilitation. As such we propose that this approach could have clinical utility to evaluate and prescribe rehabilitation in stroke patients. [ABSTRACT FROM AUTHOR]