Scleroderma: Assessment of posture, balance and pulmonary function in a cross-sectional controlled study.

Background: Systemic sclerosis leads to significant physical limitations in patients, such as diffuse weakness, skin sclerosis, loss of joint function and lung damage. This study aimed to assess posture and balance in systemic sclerosis patients and secondarily to verify correlations between such measurements and lung function.

Methods: Thirty-one patients and a similar number of control subjects matched for age, gender, weight, height and body mass index underwent postural assessment using photogrammetry, balance measurement using the Berg Balance Scale and stabilometry, and pulmonary function tests.

Findings: When compared to healthy volunteers, the patients had postural deviations in hip angle (P=0.009 in anterior view and P=0.028 for the right side), horizontal alignment of the pelvis (P=0.002 for the right side and P=0.004 for the left side), vertical alignment of the trunk (P=0.012 for the right side) and ankle angle (P=0.019 for the right side). Postural balance was similar between the two groups as assessed by the Berg Balance Scale and stabilometry. We observed significant correlations between balance measures and posture variables involving the knee and ankle, and between postural control and lung function (ratio between forced vital capacity and diffusing capacity for carbon monoxide).

Interpretation: Our results suggest that posture and balance should be assessed in systemic sclerosis patients in clinical practice, as significant postural changes and compensations are needed to maintain balance. Furthermore, it is important to monitor lung function because vascular injury impacts on postural control in these patients.