Spatial-temporal gait parameters in RA post-menopausal women fallers and non-fallers


  • Pedro Aleixo Lusophone University of Humanities and Technologies, Portugal
  • José Vaz Patto Portuguese Institute of Rheumatology, Portugal
  • João Abrantes Lusophone University of Humanities and Technologies, Portugal



Rheumatoid arthritis, Gait, Spatial-temporal parameters, Variability, Falls


This study aimed to compare spatial-temporal gait parameters and its intra-individual variability of RA post-menopausal women fallers with non-fallers. Twenty-six RA post-menopausal women were selected and answered the question: "How many times did you fall last year?". Subjects with at least one fall in previous year were allocated to fallers group. Health Assessment Questionnaire (HAQ) score was used to assess functional capacity. Optoelectrical 3D motion analyses were used to gait assessment (Vicon® system, 9 infrared cameras, 200 Hz). Subjects walked barefoot at natural and self-selected speed. Seven trials of the left and right foot-steps on a force plate were collected. Thirteen subjects had at least a fall in previous year. Fallers were older and showed higher HAQ scores (p<0.05). They yielded lower gait speed, lower cadence, lower stride length, higher stance phase, higher double support phase, and lower single support phase (p<0.001). Regarding intra-individual variability, the fallers group showed higher coefficient of variation values for all spatial-temporal gait parameters (p<0.05), except for double support phase. Age seems to be an important variable concerning falls in these patients. RA post-menopausal women with falls history yielded changes in spatial-temporal gait parameters and in its intra-individual variability, and presented a lower functional capacity.


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Alarcón, G. (1995). Epidemiology of rheumatoid arthritis. Rheumatic Disease Clinics of North America, 21(3), 589–604.

Aleixo, P., Vaz Patto, J., & Abrantes, J. (2017). Dynamic joint stiffness of the ankle in rheumatoid arthritis postmenopausal women fallers and non-fallers. Gait & Posture, 57, 324–325.

Aleixo, P., Vaz Patto, J., Moreira, H., & Abrantes, J. (2018). Gait kinematic parameters in healthy and rheumatoid arthritis postmenopausal women. Orthopedic Research Online Journal, 3(2), 1–8.

Aletaha, D., Neogi, T., Silman, A., Funovits, J., Felson, D., Bingham, C., … Hawker, G. (2010). 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis & Rheumatism, 62(9), 2569–2581.

Aydoğ, E., Bal, A., Aydoğ, S., & Cakci, A. (2006). Evaluation of dynamic postural balance using the Biodex Stability System in rheumatoid arthritis patients. Clinical Rheumatology, 25(4), 462–467.

Barn, R., Turner, D., Rafferty, D., Sturrock, R., & Woodburn, J. (2013). Tibialis posterior tenosynovitis and associated pes plano valgus in rheumatoid arthritis: electromyography, multisegment foot kinematics, and ultrasound features. Arthritis Care & Research, 65(4), 495–502.

Barrett-Connor, E., Weiss, T. W., McHorney, C. A., Miller, P. D., & Siris, E. S. (2009). Predictors of falls among postmenopausal women: results from the National Osteoporosis Risk Assessment (NORA). Osteoporosis International, 20(5), 715–722.

Bohannon, R., & Andrews, A. (2011). Normal walking speed: a descriptive meta-analysis. Physiotherapy, 97(3), 182–189.

Branco, J., Rodrigues, A., Gouveia, N., Eusébio, M., Ramiro, S., Machado, P., … Canhão, H. (2016). Prevalence of rheumatic and musculoskeletal diseases and their impact on health-related quality of life, physical function and mental health in Portugal: results from EpiReumaPt a national health survey. RMD Open, 2, e000166.

Buzzi, U., Stergiou, N., Kurz, M., Hageman, P., & Heidel, J. (2003). Nonlinear dynamics indicates aging affects variability during gait. Clinical Biomechanics, 18(5), 435–443.

Callisaya, M., Blizzard, L., Schmidt, M., Martin, K., McGinley, J., Sanders, L., & Srikanth, V. (2011). Gait, gait variability and the risk of multiple incident falls in older people: a population-based study. Age and Ageing, 40(4), 481–487.

Çimen, O., Deviren, S., & Yorgancioglu, Z. (2001). Pulmonary function tests, aerobic capacity, respiratory muscle and endurance of patients with rheumatoid arthritis. Clinical Rheumatology, 20(3), 168–173.

Derr, J. (2006). Valid paired data designs : make full use of the data without ‘“double-dipping.”’ Journal of Orthopaedic & Sports Physical Therapy, 36(2), 42–44.

Diedrich, F., & Warren, W. (1995). Why change gaits ? Dynamics of the walk-run transition. Journal of Experimental Psychology, 21(1), 183–202.

Ekdahl, C., & Broman, G. (1992). Muscle strength, endurance, and aerobic capacity in rheumatoid arthritis: a comparative study with healthy subjects. Annals of Rheumatic Disease, 51(1), 35–40.

Eppeland, S., Myklebust, G., Hodt-Billington, C., & Moe-Nilssen, R. (2009). Gait patterns in subjects with rheumatoid arthritis cannot be explained by reduced speed alone. Gait & Posture, 29(3), 499–503.

Fries, J., Spitz, P., & Young, D. (1982). The dimensions of health outcomes: the health assessment questionnaire, disability and pain scales. Journal of Rheumatology, 9(5), 789–793.

Geusens, P., Autier, P., Boonen, S., Vanhoof, J., Declerck, K., & Raus, J. (2002). The relationship among history of falls, osteoporosis, and fractures in postmenopausal women. Archives of Physical Medicine and Rehabilitation, 83(7), 903–906.

Good, P., & Hardin, J. (2003). Common errors in statistics (and how to avoid them). Hoboken, New Jersey: John Wiley & Sons, Inc.

Hakkinen, A., Hannonen, P., & Hakkinen, K. (1995). Muscle strength in healthy people and in patients suffering from recent-onset inflamatory arthritis. British Journal of Rheumatology, 34(4), 355–360.

Harlow, S., Gass, M., Hall, J., Lobo, R., Maki, P., Rebar, R., … de Villiers, T. (2012). Executive summary of the Stages of Reproductive Aging Workshop + 10: addressing the unfinished agenda of staging reproductive aging. Fertility and Sterility, 97(4), 843–851.

Hausdorff, J. M., Rios, D. A., & Edelberg, H. K. (2001). Gait variability and fall risk in community-living older adults: A 1-year prospective study. Archives of Physical Medicine and Rehabilitation, 82(8), 1050–1056.

Hochberg, M., & Spector, T. (1990). Epidemiology of rheumatoid arthritis: update. Epidemiological Review, 12, 247–252.

Khazzam, M., Long, J., Marks, R., & Harris, G. (2007). Kinematic changes of the foot and ankle in patients with systemic rheumatoid arthritis and forefoot deformity. Journal of Orthopedic Research, 25(3), 319–329.

Lamb, S., Jorstad-Stein, E., Hauer, K., & Becker, C. (2005). Development of a common outcome data set for fall injury prevention trials: the Prevention of Falls Network Europe consensus. Journal of American Geriatric Society, 53, 1618–1622.

Lázaro, M., González, A., Latorre, G., Fernández, C., & Ribera, J. (2011). Postural stability in the elderly : fallers versus non-fallers. European Geriatric Medicine, 2, 1–5.

Madsen, O., & Egsmose, C. (2001). Associations of isokinetic knee extensor and flexor strength with steroid use and walking ability in women with rheumatoid arthritis. Clinical Rheumatology, 20(3), 207–212.

Maki, B. E. (1997). Gait changes in older adults: predictors of falls or indicators of fear? Journal of the American Geriatrics Society, 45(3), 313–320.

Markenson, J. (1991). Worldwide trends in the socioeconomic impact and longterm prognosis of rheumatoid arthritis. Seminars in Arthritis and Rheumatism, 21, 4–12.

Meireles, S., Oliveira, L., Andrade, M., Silva, A., & Natour, J. (2002). Isokinetic evaluation of the knee in patients with rheumatoid arthritis. Joint Bone Spine, 69(6), 566–573.

Montero-Odasso, M., Schapira, M., Soriano, E. R., Varela, M., Kaplan, R., Camera, L. A., & Mayorga, L. M. (2005). Gait Velocity as a Single Predictor of Adverse Events in Healthy Seniors Aged 75 Years and Older. J Gerontol A Biol Sci Med Sci, 60(10), 1304–1309.

Newstead, A. H., Walden, J. G., & Gitter, A. J. (2007). Gait Variables Differentiating Fallers from Nonfallers. Journal of Geriatric Physical Therapy, 30(3), 93–101.

O’Connell, P., Lohmann, S., Kepple, T., Stanhope, S., & Gerber, L. (1998). Forefoot deformity, pain, and mobility in rheumatoid and nonarthritic subjects. Journal of Rheumatology, 25(9), 1681–1686.

Rubenstein, L. (2006). Falls in older people: epidemiology, risk factors and strategies for prevention. Age and Ageing, 35(Suppl 2), ii37-ii41.

Sadeghi, H., Allard, P., Prince, F., & Labelle, H. (2000). Symmetry and limb dominance in able-bodied gait: a review. Gait & Posture, 12(1), 34–45.

Santos, R., Reis, P., Rebelo, L., Dias, F., Rosa, C., & Queiroz, M. (1996). Health Assessment Questionnaire (versão curta): adaptação para a língua portuguesa e estudo de aplicabilidade. Acta Reumatológica Portuguesa, 21(76), 15–20.

Sekiya, N., Nagasaki, H., & Ito, H. (1997). Optimal walking in terms of variability in step length. Journal of Orthopaedic & Sports Physical Therapy, 26(5), 266–272.

Sherrington, C., Michaleff, Z. A., Fairhall, N., Paul, S. S., Tiedemann, A., Whitney, J., … Lord, S. R. (2017). Exercise to prevent falls in older adults: an updated systematic review and meta-analysis. British Journal of Sports Medicine, 51(24), 1749–1757.

Shuster, L., Rhodes, D., Gostout, B., Grossardt, B., & Rocca, W. (2010). Premature menopause or early menopause: Long-term health consequences. Maturitas, 65(2), 161–166.

Smolen, J., Breedveld, F., Eberl, G., Jones, I., Leeming, M., Wylie, G., & Kirkpatrick, J. (1995). Validity and reliability of the twenty-eight-joint count for the assessement of rheumatoid arthritis activity. Arthritis and Rheumatism, 38(1), 38–43.

Stanmore, E., Oldham, J., Skelton, D., O’Neill, T., Pilling, M., Campbell, J., & Todd, C. (2013). Risk factors for falls in adults with rheumatoid arthritis: a prospective study. Arthritis Care & Research, 65(8), 1251–1258.

Toebes, M. J. P., Hoozemans, M. J. M., Furrer, R., Dekker, J., & Van Dieën, J. H. (2012). Local dynamic stability and variability of gait are associated with fall history in elderly subjects. Gait and Posture, 36(3), 527–531.

Turner, D., Helliwell, P., Emery, P., & Woodburn, J. (2006). The impact of rheumatoid arthritis on foot function in the early stages of disease: a clinical case series. BMC Musculoskeletal Disorders, 7(1), 102.

Turner, D., Helliwell, P., Siegel, K., & Woodburn, J. (2008). Biomechanics of the foot in rheumatoid arthritis: identifying abnormal function and the factors associated with localised disease “impact”. Clinical Biomechanics, 23(1), 93–100.

Verghese, J., Holtzer, R., Lipton, R. B., & Wang, C. (2009). Quantitative gait markers and incident fall risk in older adults. J Gerontol A Biol Sci Med Sci 2009., 64(8), 896–901.

Weiss, R., Broström, E., Stark, A., Wick, M., & Wretenberg, P. (2007). Ankle/hindfoot arthrodesis in rheumatoid arthritis improves kinematics and kinetics of the knee and hip: a prospective gait analysis study. Rheumatology, 46(6), 1024–1028.

Weiss, R., Wretenberg, P., Stark, A., Palmblad, K., Larsson, P., Gröndal, L., & Broström, E. (2008). Gait pattern in rheumatoid arthritis. Gait & Posture, 28(2), 229–234.

Winter, D. (1991). The biomechanics and motor control of human gait: normal, elderly and pathological (2nd editio). Waterloo: Waterloo Biomechanics.


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How to Cite

Aleixo, P., Patto, J. V., & Abrantes, J. (2019). Spatial-temporal gait parameters in RA post-menopausal women fallers and non-fallers. Journal of Human Sport and Exercise, 14(4proc), S770-S779.