1
|
Altan O, Ekşioğlu E, Öztürk EA, Hakan Demirhan T, Kaya Z, Aytaç Eyüpoğlu S, Koşan Çulha V, Gürlek Gökçebay D, Özbek NY. Clinical Evaluation of Balance in Children With Hemophilic Arthropathy. Indian J Hematol Blood Transfus 2022; 38:698-702. [PMID: 36258722 PMCID: PMC9569260 DOI: 10.1007/s12288-022-01526-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 02/10/2022] [Indexed: 10/18/2022] Open
Abstract
Purpose Hemophilia is a hereditary coagulation disorder characterized by acute hemorrhages into the musculoskeletal system, leading eventually to arthropathy and disability. Chronic inflammation of the synovial membrane arises as a result of frequent joint hemorrhage. Proteolytic enzymes in the blood and cartilage cause deterioration after that, and joint space narrows. Chronic hemophilic arthropathy develops as a result of these unfavorable developments, which occur more quickly, especially in the target joints. Balance is a process that allows us to maintain our orientation in three-dimensional space while also regulating our body posture to avoid falling. After the central nervous system evaluates deep stimuli from sensory, visual, and auditory receptors, movement of the corresponding muscle groups is delivered. Methods The goal of this study was to investigate how impairment to deep sensory receptors (proprioception) in the arthropathic joint structure affected hemophiliacs' balance. The study comprised 34 patients with hemophilic arthropathy, and 34 age and weight matched healthy volunteers. Results When balance tests of patients with hemophilic arthropathy were compared to healthy controls, hemophiliacs had a greater risk of falling. As the degree of arthropathy increased, so did the risk of falling and balance test values in individuals with hemophilic arthropathy. Conclusions Treatment and coagulation factor prophylaxis to prevent the onset of arthropathy will improve patients' quality of life and reduce morbidity associated with frequent falls and bleeding. Supplementary Information The online version contains supplementary material available at 10.1007/s12288-022-01526-0.
Collapse
Affiliation(s)
- Orcan Altan
- Pediatric Hematology/Oncology, Ankara Child Health and Diseases Hematology and Oncology Training and Research Hospital, University of Health Sciences, Ziraat Mah. Irfan Bastug Cd. Kurtdereli Sk. No: 10, 06110 Ankara, Turkey
| | - Emel Ekşioğlu
- Physical Therapy and Rehabilitation, University of Health Sciences Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Erhan Arif Öztürk
- Physical Therapy and Rehabilitation, University of Health Sciences Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Tülin Hakan Demirhan
- Pediatric Radiology, Ankara Child Health and Diseases Hematology and Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Zühre Kaya
- Pediatric Hematology, Gazi University Faculty of Medicine, Ankara, Turkey
| | | | - Vildan Koşan Çulha
- Pediatric Hematology/Oncology, Ankara Child Health and Diseases Hematology and Oncology Training and Research Hospital, University of Health Sciences, Ziraat Mah. Irfan Bastug Cd. Kurtdereli Sk. No: 10, 06110 Ankara, Turkey
| | - Dilek Gürlek Gökçebay
- Pediatric Hematology/Oncology, Ankara Child Health and Diseases Hematology and Oncology Training and Research Hospital, University of Health Sciences, Ziraat Mah. Irfan Bastug Cd. Kurtdereli Sk. No: 10, 06110 Ankara, Turkey
| | - Namık Yaşar Özbek
- Pediatric Hematology/Oncology, Ankara Child Health and Diseases Hematology and Oncology Training and Research Hospital, University of Health Sciences, Ziraat Mah. Irfan Bastug Cd. Kurtdereli Sk. No: 10, 06110 Ankara, Turkey
| |
Collapse
|
2
|
Scaturro D, Vitagliani F, Tomasello S, Mangano MS, Signa G, Letizia Mauro G. Postural Assessment Systems in the Prevention of Haemophilic Arthropathy: A Narrative Review. J Funct Morphol Kinesiol 2022; 7:jfmk7030068. [PMID: 36135426 PMCID: PMC9504687 DOI: 10.3390/jfmk7030068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 11/17/2022] Open
Abstract
This narrative review aims to give an overview of some postural evaluation systems currently used in patients with haemophilia. Among them, first, we analyse the HJHS scale, recognized as a specific evaluation tool for haemophilic arthropathy. Second, we focus on other systems usually used in non-haemophilic patients that have also shown good applicability in this patient category, such as gait analysis, stabilometry, and baropodometric examination. This review underlines the use these tools could have in clinical practice to identify the early postural alterations in patients with haemophilia and set up personalised rehabilitation programs.
Collapse
Affiliation(s)
- Dalila Scaturro
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90127 Palermo, Italy
- Correspondence: ; Tel.: +39-3206945411
| | - Fabio Vitagliani
- Faculty of Medicine and Surgery, University of Catania, 95100 Catania, Italy
| | - Sofia Tomasello
- Faculty of Medicine and Surgery, University of Palermo, 90127 Palermo, Italy
| | | | - Gabriele Signa
- Faculty of Medicine and Surgery, University of Catania, 95100 Catania, Italy
| | - Giulia Letizia Mauro
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90127 Palermo, Italy
| |
Collapse
|
3
|
Etzweiler D, Albisetti M, Meichtry A, Huber EO. The effect of age on the pressure pain threshold of asymptomatic ankles and knees in young individuals with haemophilia. Haemophilia 2021; 27:683-689. [PMID: 34015164 DOI: 10.1111/hae.14344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 04/24/2021] [Accepted: 05/03/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Despite adequate medical treatment, many young adults with haemophilia develop joint alterations-especially in ankles and knees. Undetected over years, subtle structural changes cause subclinical symptoms, before problems become obvious. To objectify these silent pressure pains, the pressure pain threshold (PPT) can be measured by algometry. AIM The aim was to investigate and compare the effect of age on PPTs in asymptomatic ankles and knees between boys and young adults with haemophilia and age-matched controls, in order to gain better knowledge about the alteration of the periarticular structures with increasing age. MATERIAL AND METHODS Nineteen persons with haemophilia (PwH; severe or moderate; 8-30 years) and 19 age-matched controls with 'healthy' ankles and knees were recruited. Asymptomatic joints with a Haemophilia Joint Health Score = 0 were included. The PPT was measured on four periarticular points per joint, and the data were analysed with a linear mixed model. RESULTS The PPT of the control group increased with age, whereas the PPT of the PwH decreased. The difference in age effect per year in kPa between PwH and controls was as follows: β [95%-CI]: -15.41 [-31.63; 0.79]. Although the result was not statistically significant (p = .08), a clear tendency was shown. CONCLUSION The results suggest that subclinical alterations in the periarticular structures of these joints may evolve unnoticed over time. However, further research is warranted to determine whether this observed trend is confirmed in a larger sample and at what age the PPT begins to decrease in PwH compared to controls.
Collapse
Affiliation(s)
- Denise Etzweiler
- Division of Haematology, University Children's Hospital Zurich, Zurich, Switzerland.,School of Health Professions, Institute of Physiotherapy, University of Applied Sciences, Winterthur, Switzerland
| | - Manuela Albisetti
- Division of Haematology, University Children's Hospital Zurich, Zurich, Switzerland
| | - André Meichtry
- School of Health Professions, Institute of Physiotherapy, University of Applied Sciences, Winterthur, Switzerland
| | - Erika O Huber
- School of Health Professions, Institute of Physiotherapy, University of Applied Sciences, Winterthur, Switzerland
| |
Collapse
|
4
|
Tat NM, Tat AM, Oner AF, Karaman K, Kaplan S, Can F. Static postural balance evaluation and an investigation of the relationship with joint health in children with severe haemophilia: a controlled cross-sectional study. Haemophilia 2021; 27:e245-e252. [PMID: 33486846 DOI: 10.1111/hae.14240] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 11/30/2020] [Accepted: 12/12/2020] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Recurrent hemarthroses disturbing force/movement control are likely to impair postural balance. AIM To investigate the possible changes in static postural balance parameters in children with haemophilia (CwH) and to reveal its relationship with Haemophilia Joint Health Score (HJHS). METHODS Twenty-one CwH aged 6-18 who had haemophilic arthropathy in at least one lower limb joint and 21 healthy peers were evaluated by using a force platform. Centre of pressure (CoP) signals were displayed as a map in both anteroposterior direction (APD) and mediolateral direction (MLD) by statokinesigram. Accordingly, the amplitude, velocity and standard deviation of CoP displacements along with the perimeter and ellipse area were measured. Assessments were made under eyes opened and eyes closed in bipedal stance for 60 s. Joint health and muscle strength were evaluated with HJHS and digital dynamometer, respectively. RESULTS Velocity and amplitude of CoP displacements in MLD were increased in CwH (p˂0.05). It was also found that these parameters were moderate correlated with the clinical score of the lower limb joints (p˂0.05). In CwH, standard deviation of CoP displacements in the APD was significantly higher in eyes closed, while standard deviation in MLD was significantly higher in eyes opened (p˂0.05). CONCLUSION Disturbances during bipedal stance reveal the need for balance evaluation in CwH. Increased mediolateral oscillations may be an early sign of disorders of the musculoskeletal system in CwH. In addition to improving joint health, postural balance exercises that increase MLD stability have to be included in the rehabilitation programme of CwH.
Collapse
Affiliation(s)
- Necati M Tat
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Necmettin Erbakan University, Konya, Turkey
| | - Ayse M Tat
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Necmettin Erbakan University, Konya, Turkey
| | - Ahmet F Oner
- Faculty of Medicine, Department of Pediatric Hematology and Oncology, Yuzuncu Yil University, Van, Turkey
| | - Kamuran Karaman
- Faculty of Medicine, Department of Pediatric Hematology and Oncology, Yuzuncu Yil University, Van, Turkey
| | - Seyhmus Kaplan
- Faculty of Medicine, Department of Sports Medicine, Yuzuncu Yil University, Van, Turkey
| | - Filiz Can
- Faculty of Physical Therapy and Rehabilitation, Department of Orthopaedic Rehabilitation, Hacettepe University, Ankara, Turkey
| |
Collapse
|
5
|
García-Massó X, Ye-Lin Y, Garcia-Casado J, Querol F, Gonzalez LM. Assessment of haemophilic arthropathy through balance analysis: a promising tool. Comput Methods Biomech Biomed Engin 2019; 22:418-425. [PMID: 30714398 DOI: 10.1080/10255842.2018.1561877] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The purpose of this study was to develop a tool able to distinguish between subjects who have haemophilic arthropathy in lower limbs and those who do not by analyzing the centre of pressure displacement. The second objective was to assess the possible different responses of haemophiliacs and healthy subjects by creating a classifier that could distinguish between both groups. Fifty-four haemophilic patients (28 with and 26 without arthropathy) and 23 healthy subjects took part voluntarily in the study. A force plate was used to measure postural stability. A total of 276 centre of pressure displacement parameters were calculated under different conditions: unipedal/bipedal balance with eyes open/closed. These parameters were used to design a Quadratic Discriminant Analysis classifier. The arthropathy versus non-arthropathy classifier had an overall accuracy of 97.5% when only 10 features were used in its design. Similarly, the haemophiliac versus non-haemophiliac classifier had an overall accuracy of 97.2% when only 7 features were used. In conclusion, an objective haemophilic arthropathy in lower limbs evaluation system was developed by analyzing centre of pressure displacement signals. The haemophiliac vs. non-haemophiliac classifier designed was also able to corroborate the existing differences in postural control between haemophilic patients (with and without arthropathy) and healthy subjects.
Collapse
Affiliation(s)
- Xavier García-Massó
- a Departamento de Didáctica de la Expresión Musical Plástica y Corporal , Universidad de Valencia , Valencia , España
| | - Yiyao Ye-Lin
- b Centro de Investigación e Innovación en Bioingeniería (CI2B) , Universitat Politècnica de València , Valencia , España
| | - Javier Garcia-Casado
- b Centro de Investigación e Innovación en Bioingeniería (CI2B) , Universitat Politècnica de València , Valencia , España
| | - Felipe Querol
- c Departamento de Fisioterapia , Universidad de Valencia , Valencia , España.,d Unidad de Trombosis y Hemostasia Hospital Universitario La FE , Valencia , España
| | - Luis-Millan Gonzalez
- e Departamento de Educación Física y Deportiva , Universidad de Valencia , Valencia , España
| |
Collapse
|
6
|
Tajali S, Rouhani M, Mehravar M, Negahban H, Sadati E, Oskouei AE. Effects of External Perturbations on Anticipatory and Compensatory Postural Adjustments in Patients with Multiple Sclerosis and a Fall History. Int J MS Care 2018; 20:164-172. [PMID: 30150900 DOI: 10.7224/1537-2073.2016-098] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background Although previous studies have investigated postural adjustment mechanisms in patients with multiple sclerosis (MS), it seems that no study has yet investigated the relationship between anticipatory and compensatory postural adjustments (APAs and CPAs, respectively) and falls. Methods Seventeen MS fallers, 17 MS nonfallers, and 15 controls were exposed to a series of expected and unexpected backward pull perturbations applied at the trunk level. The electrical activity of 12 leg and trunk muscles as well as center of pressure displacement were recorded. Results The MS fallers had delayed muscle activity onsets compared with MS nonfallers and controls. In addition, a significantly lower level of muscle activity during APAs was detected in MS fallers compared with controls. Moreover, in the unexpected condition of perturbation, significantly smaller CPA was observed in MS fallers compared with controls. Both groups of patients with MS required more time to stabilize their center of pressure after both types of perturbations compared with controls. Conclusions The inability to produce efficient APAs and CPAs during perturbations may explain the high rates of postural instability and falls in patients with MS. Findings from this study provide a background for the development of perturbation-based training programs aimed at balance improvement and fall prevention by restoring mechanisms underlying balance impairments.
Collapse
|
7
|
Suckling LB, Stephensen D, Cramp MC, Mahaffey R, Drechsler WI. Identifying biomechanical gait parameters in adolescent boys with haemophilia using principal component analysis. Haemophilia 2017; 24:149-155. [DOI: 10.1111/hae.13362] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2017] [Indexed: 12/22/2022]
Affiliation(s)
- L. B. Suckling
- School of Health, Sport & Bioscience; University of East London; Stratford London UK
| | | | - M. C. Cramp
- Allied Health Professions; University of the West of England; Bristol UK
| | - R. Mahaffey
- School of Sport; Health and Applied Sciences; St Mary's University Twickenham; UK
| | - W. I. Drechsler
- Faculty of Life Sciences & Medicine; Kings College London; London UK
| |
Collapse
|
8
|
Lobet S, McCarthy A, Hermans C, Peerlinck K, Matricali GA, Staes F, Deschamps K. Biomechanical markers and theoretical concepts related to haemophilic ankle and subtalar joint arthropathy: introducing the term ‘haemophilic tarsal pan-arthropathy’. Haemophilia 2017; 23:e250-e258. [DOI: 10.1111/hae.13202] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2017] [Indexed: 12/22/2022]
Affiliation(s)
- S. Lobet
- Secteur des Sciences de la Santé; Institut de Recherche Expérimentale et Clinique; Computer Assisted Robotic Surgery (CARS); Université catholique de Louvain; Brussels Belgium
- Cliniques universitaires Saint-Luc; Service d'hématologie; Brussels Belgium
- Cliniques universitaires Saint-Luc; Service de médecine physique et réadaptation; Brussels Belgium
| | - A. McCarthy
- Katharine Dormandy Haemophilia & Thrombosis Centre; Royal Free Hospital; London UK
| | - C. Hermans
- Cliniques universitaires Saint-Luc; Service d'hématologie; Brussels Belgium
| | - K. Peerlinck
- Centre for Molecular and Vascular Biology; KU Leuven; Leuven Belgium
| | - G. A. Matricali
- Department of Development & Regeneration; KU Leuven; Leuven Belgium
- Department of Orthopaedics; Foot & Ankle Unit; University Hospitals Leuven; KU Leuven; Leuven Belgium
- Institute of Orthopaedic Research & Training; KU Leuven; Leuven Belgium
| | - F. Staes
- Department of Rehabilitation Sciences; Musculoskeletal Rehabilitation Research Group; KU Leuven; Leuven Belgium
| | - K. Deschamps
- Department of Rehabilitation Sciences; Musculoskeletal Rehabilitation Research Group; KU Leuven; Leuven Belgium
- Department of Podiatry; Artevelde University College; Ghent Belgium
- Department of Podiatry; Parnasse-ISEI; Haute Ecole Leonard de Vinci; Bruxelles Belgium
| |
Collapse
|
9
|
Pérez-Alenda S, Carrasco JJ, Aguilar-Rodríguez M, Martínez-Gómez L, Querol-Giner M, Cuesta-Barriuso R, Torres-Ortuño A, Querol F. Balance evaluation in haemophilic preadolescent patients using Nintendo Wii Balance Board®. Haemophilia 2016; 23:e18-e24. [DOI: 10.1111/hae.13128] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2016] [Indexed: 12/18/2022]
Affiliation(s)
- S. Pérez-Alenda
- Department of Physiotherapy; University of Valencia; Valencia Spain
- Haemostasis and Thrombosis Unit; University and Polytechnic Hospital La Fe; Valencia Spain
| | - J. J. Carrasco
- Department of Physiotherapy; University of Valencia; Valencia Spain
- Intelligent Data Analysis Laboratory; University of Valencia; Valencia Spain
| | - M. Aguilar-Rodríguez
- Department of Physiotherapy; University of Valencia; Valencia Spain
- Rehabilitation Service; University and Polytechnic Hospital La Fe; Valencia Spain
| | | | - M. Querol-Giner
- Department of Physiotherapy; University of Valencia; Valencia Spain
- Servicio de Rehabilitación; Hospital de Sagunto; Valencia Spain
| | - R. Cuesta-Barriuso
- Department of Physiotherapy; School of Biomedical and Health Science; European University of Madrid; Madrid Spain
- Real Fundación Victoria Eugenia; Madrid Spain
- Federación Española de Hemofilia; Madrid Spain
| | - A. Torres-Ortuño
- Department of Psychiatry and Social Psychology; Faculty of Medicine; University of Murcia; Murcia Spain
| | - F. Querol
- Department of Physiotherapy; University of Valencia; Valencia Spain
- Haemostasis and Thrombosis Unit; University and Polytechnic Hospital La Fe; Valencia Spain
| |
Collapse
|
10
|
Pavione Rodrigues Pereira R, Nascimento Fagundes S, Surry Lebl A, Azevedo Soster L, Machado MG, Koch VH, Tanaka C. Children with nocturnal enuresis have posture and balance disorders. J Pediatr Urol 2016; 12:216.e1-6. [PMID: 27290613 DOI: 10.1016/j.jpurol.2016.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 05/04/2016] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Integration of the neuromuscular system is required for maintaining balance and adequate voiding function. Children with enuresis have delayed maturation of the motor cortex, with changes in the sensory and motor systems. Along with various alterations, including the genetic, hormonal, behavioral, and sleep disturbances, and neuromotor and sensory deficits associated with nocturnal enuresis (NE) in children and adults, a consistent alteration in the posture of children with NE has been observed in the current practice. Because posture and the balance control system are strongly connected, this study aimed to investigate posture and balance in children and teenagers with NE. MATERIAL AND METHODS A total of 111 children with enuresis were recruited to the enuretic group (EG) and 60 asymptomatic children made up the control group (CG). The participants were divided into two age subgroups: (A) 7-11 years old, N = 77 for EG/A, N = 38 for CG/A; and (B) 12-16 years old, N = 34 for EG/B, N = 22 for CG/B. Balance was assessed using an electronic force plate (100 Hz) to calculate the area of the center of pressure (COP) displacement. The COP is the point that results from the action of vertical forces projected onto the force plate. Sensory integration was analyzed using a 60-s trial with the subject standing under four conditions: (1) eyes open, stable surface; (2) eyes closed, stable surface; (3) eyes open, unstable surface; (4) eyes closed, unstable surface. Posture was assessed by placing reflective anatomical landmarks on the anterior superior iliac spine, the posterior superior iliac spine, the greater trochanter, and lateral malleolus. A photograph was taken while the subject stood quietly. The angles were obtained from landmark connections using software to assess the following posture variables: pelvic ante/retroversion and pelvic ante/retropulsion. RESULTS The EG showed a greater area of COP displacement compared with the CG under all four sensory conditions and both subgroups, except for EG/B in condition 3. Regarding posture, EG showed higher pelvic anteversion angles than CG. CONCLUSIONS Enuretic children showed forward inclination of the pelvis and had worse balance compared with control children.
Collapse
Affiliation(s)
- R Pavione Rodrigues Pereira
- Department of Physiotherapy, Communication Science & Disorders, Occupational Therapy, University of Sao Paulo, School of Medicine, Sao Paulo, Brazil.
| | - S Nascimento Fagundes
- Pediatric Nephrology Unit, Instituto da Criança do Hospital das Clínicas, University of Sao Paulo, School of Medicine, Sao Paulo, Brazil
| | - A Surry Lebl
- Pediatric Nephrology Unit, Instituto da Criança do Hospital das Clínicas, University of Sao Paulo, School of Medicine, Sao Paulo, Brazil
| | - L Azevedo Soster
- Pediatric Sleep Laboratory, Instituto da Criança do Hospital das Clínicas, University of Sao Paulo, School of Medicine, Sao Paulo, Brazil
| | - M G Machado
- Pediatric Urology Unit, Hospital das Clínicas, University of Sao Paulo, School of Medicine, Sao Paulo, Brazil
| | - V H Koch
- Pediatric Nephrology Unit, Instituto da Criança do Hospital das Clínicas, University of Sao Paulo, School of Medicine, Sao Paulo, Brazil
| | - C Tanaka
- Department of Physiotherapy, Communication Science & Disorders, Occupational Therapy, University of Sao Paulo, School of Medicine, Sao Paulo, Brazil
| |
Collapse
|
11
|
Stephensen D, Drechsler WI, Scott OM. Influence of ankle plantar flexor muscle architecture and strength on gait in boys with haemophilia in comparison to typically developing children. Haemophilia 2013; 20:413-20. [DOI: 10.1111/hae.12317] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2013] [Indexed: 12/26/2022]
Affiliation(s)
- D. Stephensen
- School of Health, Sport and Bioscience; University of East London; London UK
| | - W. I. Drechsler
- School of Health, Sport and Bioscience; University of East London; London UK
| | - O. M. Scott
- School of Health, Sport and Bioscience; University of East London; London UK
| |
Collapse
|
12
|
Stephensen D, Drechsler WI, Scott OM. Outcome measures monitoring physical function in children with haemophilia: a systematic review. Haemophilia 2013; 20:306-21. [PMID: 24252123 DOI: 10.1111/hae.12299] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2013] [Indexed: 12/13/2022]
Abstract
Our objective was to provide a synthesis of measurement properties for performance-based outcome measures used to evaluate physical function in children with haemophilia. A systematic review of articles published in English using Medline, PEDro, Cinahl and The Cochrane Library electronic databases was conducted. Studies were included if a performance-based method, clinical evaluation or measurement tool was used to record an aspect of physical function in patients with haemophilia aged ≤ 18 years. Recording of self-perceived or patient-reported physical performance, abstracts, unpublished reports, case series reports and studies where the outcome measure was not documented or cross-referenced was excluded. Description of outcome measures, patient characteristics, measurement properties for construct validity, internal consistency, repeatability, responsiveness and feasibility was extracted. Data synthesis of 41 studies evaluating 14 measures is reported. None of the outcome measures demonstrated the requirements for all the measurement properties. Data on validity and test-retest repeatability were most lacking together with studies of sufficient size. Measurement of walking and muscle strength demonstrated good repeatability and discriminative properties; however, correlation with other measures of musculoskeletal impairment requires investigation. The Haemophilia Joint Health Score demonstrated acceptable construct validity, internal consistency and repeatability, but the ability to discriminate changes in physical function is still to be determined. Rigorous evaluation of the measurement properties of performance-based outcome measures used to monitor physical function of children with haemophilia in larger collaborative studies is required.
Collapse
Affiliation(s)
- D Stephensen
- School of Health, Sport and Bioscience, University of East London, London, UK; Kent Haemophilia Centre, Kent and Canterbury Hospital, Canterbury, UK
| | | | | |
Collapse
|
13
|
Souza FMB, McLaughlin P, Pereira RP, Minuque NP, Mello MHM, Siqueira C, Villaça P, Tanaka C. The effects of repetitive haemarthrosis on postural balance in children with haemophilia. Haemophilia 2013; 19:e212-7. [PMID: 23534559 DOI: 10.1111/hae.12106] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2013] [Indexed: 12/23/2022]
Abstract
Sensory information from visual, vestibular and proprioceptive systems is necessary to control posture and balance. Impairment in proprioception due to repetitive joints bleeding may lead to a deficit in postural balance which, in turn, leads to high joint stress and risk of bleeding recurrence. Despite the increase in attention in this field during the past few years, the data concerning to how bleeds can affect postural control in children with haemophilia (CWH) remain scarce. This study aimed to evaluate the postural balance in CWH. Twenty CWH Haemophilia Group (HG) and 20 age-matched children Control Group (CG) were recruited to this study. A force plate was used to record centre of pressure (COP) displacement under four different postural conditions during quiet standing: eyes open on firm surface, eyes open on foam surface, eyes closed on firm surface and eyes closed on a foam surface. Variables of COP as sway area and mean velocity and in anterior-posterior (y) medio-lateral (x) direction were processed and for each variable sensory, quotients were calculated and compared between groups. No differences were found in visual and vestibular quotients variables between groups. A higher value was found in sway area variable on proprioception quotient in the HG when compared with CG (P = 0.042). CWH with repetitive joint bleed on lower limbs showed differences in postural balance when compared with non-haemophiliac children. The identification of early balance impairments in CWH can help us understand better the effects of bleeds inside joints on postural control and plan a more effective preventive and rehabilitative treatment.
Collapse
Affiliation(s)
- F M B Souza
- Physical Therapy, Communication Disorders and Occupational Therapy, University of São Paulo, São Paulo, Brazil
| | | | | | | | | | | | | | | |
Collapse
|
14
|
Cunha ÂGJ, Nunes MPT, Ramos RT, Carvalo-Pinto RM, Boffino CC, Martins FC, Tanaka C. Balance disturbances in asthmatic patients. J Asthma 2012; 50:282-6. [PMID: 23234251 DOI: 10.3109/02770903.2012.750668] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The aim of this study was to investigate balance control in asthmatic patients. METHODS Thirty subjects with controlled persistent asthma were compared with 30 non-asthmatic subjects who were matched by age and sex. Individuals who had received psychiatric treatment, demonstrated chronic musculoskeletal pain, had limited joint movements, or showed vestibular or other equilibrium disorders were excluded from both the groups to avoid biomechanical bias in the dynamic posturography. Balance control was evaluated with the subject standing still on a force platform under four different sensory test conditions. These conditions combined the subject's eyes being opened or closed with a fixed or mobile force platform. A mobile platform provides a somatosensory perturbation, and when associated with the eyes closed condition, only vestibular information is available to moderate balance control. Sensory manipulation provides a more sensitive condition to differentiate postural control between populations or pathologies. Data were sampled at 100 Hz in three 20-second trials and four postural conditions were assessed. The center of pressure (CoP) displacement values were used to calculate area and velocity in the medial-lateral and forward-backward directions. A two-factor analysis of variance with repeated measurements was applied to the data. RESULTS In comparison to the control group, the asthma group demonstrated a greater area of CoP displacement in conditions using the mobile force platform (with eyes opened or closed) and a higher velocity in forward-backward direction on the mobile platform with the eyes closed. CONCLUSION Asthmatic individuals presented a greater area for the CoP displacement under somatosensory perturbations and a higher velocity in the forward-backward direction when vestibular information only was made available. Our data suggest that balance needs to be evaluated in asthmatic patients.
Collapse
Affiliation(s)
- Ângelo G J Cunha
- Department of Internal Medicine, University of Sao Paulo Medical School, Sao Paulo, SP, Brazil.
| | | | | | | | | | | | | |
Collapse
|