Higher Disease and Pain Severity and Fatigue and Lower Balance Skills Are Associated with Higher Prevalence of Falling among Individuals with the Inflammatory Disease of Neuromyelitis Optica Spectrum Disorder (NMOSD)
Abstract
:1. Introduction
2. Methods
2.1. Procedures
2.2. Participants
2.2.1. Persons with Neuromyelitis Optica Spectrum Disorder (NMOSD)
2.2.2. Healthy Controls
2.3. Tools
2.3.1. Sociodemographic and Anthropometric Information
2.3.2. Disability Status and Illness Duration
2.3.3. Falling Incidence and Prevalence
2.3.4. Fear of Falling: Fall Efficacy Scale
2.4. Pain
2.5. Fatigue
2.6. Balance
2.7. Cognitive Impairment; Mini-Mental Sate Examination
3. Aquaporin-4 Immunoglobulin G (AQP4-IgG)
4. Statistical Analyses
5. Results
5.1. Sociodemographic and Illness-Related Information between Persons with NMOSD and Healthy Controls
5.2. Odds of Falling in NMOSD Patients and Healthy Controls
5.3. Sociodemographic and Illness-Related Dimensions between Fallers and Non-Fallers among NMOSD Patients
5.4. Predicting Falling in NMOSD Patients
6. Discussion
7. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Variables | NMOSD | Healthy Control | Statistics |
---|---|---|---|
N | 95 | 100 | |
M (SD) | M (SD) | ||
Age, years | 34.89 (9.41) | 35.99 (9.02) | t(193) = 0.81, d = 0.11 (T) |
n/n (%/%) | n/n (%/%) | ||
Sex; female/male | 67/28 (70.5/29.5) | 79/21 (79/21) | X2(N = 195, df = 1) = 1.86 |
Education (diploma/higher diploma) | 44/51 (46.3/53.6) | 65/35 (35/65) | X2(N = 195, df = 1) = 0.80 |
- | |||
AQP 4-Ab; positive, n (%) | 34 (35.7) | - | - |
Disease modifying therapy (rituximab/other) | 11/84 (11.6/88.4) | - | - |
Faller | Non-Faller | Non-Adjusted | Adjusted by Sex and Age | |||
---|---|---|---|---|---|---|
OR (95% CI) | p-Value | OR (95% CI) | p-Value | |||
Patients; n (%) | 85 (85) | 15 (15) | 3.02 (1.51–6.03) | 0.002 | 2.50 (1.22–5.12) | 0.013 |
Control; n (%) | 33 (34.7) | 62 (65.3) |
Groups | Statistics | ||
---|---|---|---|
Dimensions | Fallers | Non-Fallers | X2-Tests |
N | 33 | 62 | |
n (%) | n (%) | ||
Sex; female | 23 (69.7%) | 44 (71%) | X2(N = 95, df = 1) = 0.02 |
Education; Higher-diploma | 17 (68%) | 34 (54.8%) | X2(N = 95, df = 1) = 1.27 |
AQP 4-Ab; positive | 12 (36.4%) | 22 (35.5%) | X2(N = 95, df = 1) = 0.45 |
M (SD) | M (SD) | t-tests | |
Age; mean (SD) | 36.85 (9.18) | 34.03 (9.45) | t(95) = 1.30, d = 0.30 (S) |
Disease duration; years | 6.57 (5.14) | 3.95 (2.77) | t(95) = 3.10 **, d = 0.63 (M) |
BMI | 24.09 (4.18) | 24.48 (4.03) | t(95) = 0.40, d = 0.09 (T) |
Pain | 4.69 (1.52) | 2.49 (1.12) | t(95) = 8.02 ***, d = 1.65 (L) |
Balance score (BBS) | 40.30 (11.09) | 52.64 (3.02) | t(95) = 8.02 ***, d = 1.52 (L) |
Fatigue (FFS) | 52.73 (11.64) | 35.86 (6.99) | t(95) = 8.99 ***, d = 1.76 (L) |
Fear of falling (FES-I) | 48.25 (7.92) | 21.50 (4.53) | t(95) = 18.77 ***, d = 4.15 (L) |
Mini Mental State Examination | 29.54 (1.12) | 28.82 (2.12) | t(95) = 1.82, d = 0.42 (S) |
Median (range) | Median (range) | U-test | |
Current EDSS | 3 (0–6) | 1 (0–2) | Z = 6.26 *** |
Non-Adjusted Analysis | Adjusted Analysis | |||||||
---|---|---|---|---|---|---|---|---|
OR (95% CI) | Wald | df | p | OR (95% CI) | Wald | df | p | |
Pain | 3.26 (2.06–5.16) | 25.41 | 1 | <0.001 | 2.11 (1.21–3.66) | 6.98 | 1 | 0.008 |
BBS | 0.81 (0.74–0.89) | 18.58 | 1 | <0.001 | 0.91 (0.75–1.09) | 1.16 | 1 | 0.282 |
FSS | 1.21 (1.12–1.30) | 25.46 | 1 | <0.001 | 1.28 (1.05–1.56) | 6.18 | 1 | 0.013 |
MMSE | 1.30 (0.96–1.76) | 2.965 | 1 | 0.085 | 1.55 (0.69–3.46) | 1.12 | 1 | 0.290 |
FES | 1.76 (1.12–2.76) | 6.07 | 1 | 0.014 | 1.71 (1.10–2.67) | 5.57 | 1 | 0.018 |
Pain | FSS | FES | |
---|---|---|---|
Statistic | Value (95% CI) | Value (95% CI) | Value (95% CI) |
AUC | 0.97 (0.94–1.00) | 0.96 (0.91–1.00) | 0.99 (0.98–1.00) |
Sensitivity | 0.92 (0.75–0.99) | 0.88 (0.70–0.98) | 0.96 (0.82–1.00) |
Specificity | 0.77 (0.65–0.87) | 0.93 (0.84–0.98) | 1.00 (0.93–1.00) |
Positive Predictive Value | 0.63 (0.52–0.733) | 0.85 (0.67–0.94) | 1.00 (0.92–1.00) |
Negative Predictive Value | 0.96 (0.86–0.99) | 0.95 (0.87–0.98) | 0.98 (0.88–1.00) |
Accuracy | 0.82 (0.72–0.89) | 0.92 (0.84–0.97) | 0.99 (0.93–1.00) |
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Barzegar, M.; Sadeghi Bahmani, D.; Mirmosayyeb, O.; Azarbayejani, R.; Afshari-Safavi, A.; Vaheb, S.; Nehzat, N.; Dana, A.; Shaygannejad, V.; Motl, R.W.; et al. Higher Disease and Pain Severity and Fatigue and Lower Balance Skills Are Associated with Higher Prevalence of Falling among Individuals with the Inflammatory Disease of Neuromyelitis Optica Spectrum Disorder (NMOSD). J. Clin. Med. 2020, 9, 3604. https://doi.org/10.3390/jcm9113604
Barzegar M, Sadeghi Bahmani D, Mirmosayyeb O, Azarbayejani R, Afshari-Safavi A, Vaheb S, Nehzat N, Dana A, Shaygannejad V, Motl RW, et al. Higher Disease and Pain Severity and Fatigue and Lower Balance Skills Are Associated with Higher Prevalence of Falling among Individuals with the Inflammatory Disease of Neuromyelitis Optica Spectrum Disorder (NMOSD). Journal of Clinical Medicine. 2020; 9(11):3604. https://doi.org/10.3390/jcm9113604
Chicago/Turabian StyleBarzegar, Mahdi, Dena Sadeghi Bahmani, Omid Mirmosayyeb, Reyhaneh Azarbayejani, Alireza Afshari-Safavi, Saeed Vaheb, Nasim Nehzat, Afshin Dana, Vahid Shaygannejad, Robert W. Motl, and et al. 2020. "Higher Disease and Pain Severity and Fatigue and Lower Balance Skills Are Associated with Higher Prevalence of Falling among Individuals with the Inflammatory Disease of Neuromyelitis Optica Spectrum Disorder (NMOSD)" Journal of Clinical Medicine 9, no. 11: 3604. https://doi.org/10.3390/jcm9113604