Static and Dynamic Balance Is Impaired in Patients With Long-Term, Well-Controlled Acromegaly: A Cross-Sectional Study

Abstract

Objective

Balance impairment is an underrecognized complication of acromegaly with potentially serious consequences for affected patients. In this study, we aimed to assess the balance in patients with long-term acromegaly compared to non-acromegalic controls.

Design

Cross-sectional study.

Patients and Measurements

Seventeen patients with acromegaly and 17 age- and sex-matched controls were examined using a force platform measuring the Centre of Pressure area (CoP_area) and velocity (CoP_velocity), the timed up-and-go (TUG) test, hand grip and knee extension dynamometry, nerve conduction measurements, visual acuity tests, and questionnaires concerning fear of falling and joint pain (Falls Efficacy Scale [FES-I] and Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]). Descriptive statistics and linear regression analyses were used to compare groups.

Results

Compared to controls, participants with acromegaly (mean acromegaly duration 13 [±8.8] years, latest mean IGF-I standard deviation score 1.2 [±1.59]) had significantly increased CoP_area adjusted for neural and visual function. When performing a difficult executive task, the CoP_area was impaired, both with (β: 2.24 [1.29; 3.92], p = 0.01) and without (β: 2.09 [1.02; 4.26], p = 0.04) a cushion under their feet, as compared to controls. Mean TUG time was significantly higher in patients with acromegaly than controls (β: 1.24 [0.07; 2.42], p = 0.04), and correlated with self-reported joint pain (β: 0.04 [0.0004; 0.08], p = 0.05).

Conclusions

Both static and dynamic balance is impaired in patients with long-term controlled acromegaly, warranting clinical attention. Further studies are needed to address therapeutic options for this overlooked and potentially serious complication.