Deficits of ankle muscle strength not found in children, adolescents and young adults with haemophilic ankle arthropathy

Lobet, Sébastien; Croisier, Jean-Louis; Lantin, Anne-Catherine; Hermans, Cédric; Peerlinck, Katheliijne; Vandesande, Jan; Pialat, Jean‐Baptiste; Deschamps, Kevin

doi:10.1111/hae.13274

Cited by 6 publications

(6 citation statements)

References 36 publications

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“…We previously reported on isokinetic muscle strength in the same CAAwH group, finding it unaltered in TTJ and STJ arthropathy. There were no differences observed between affected and non‐affected sides in CAAwH with unilateral arthropathy.…”

Section: Discussionmentioning

confidence: 69%

“…Stephensen et al 22 identified ankle plantarflexor muscle atrophy in children with haemophilia using ultrasound images. In their study, nineteen boys with severe haemophilia aged 6-12 years and a history of minimum of three bleeds into the same ankle since birth showed smaller lateral We previously reported on isokinetic muscle strength in the same CAAwH group, 23 finding it unaltered in TTJ and STJ arthropathy. There were no differences observed between affected and non-affected sides in CAAwH with unilateral arthropathy.…”

Section: Discussionmentioning

confidence: 78%

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Assessment of passive musculoarticular ankle stiffness in children, adolescents and young adults with haemophilic ankle arthropathy

et al. 2018

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Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 78%

Assessment of passive musculoarticular ankle stiffness in children, adolescents and young adults with haemophilic ankle arthropathy

et al. 2018

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“…As such, Stephensen et al 7 demonstrated that children with haemophilia (CwH) with a history of structural ankle damage had a significant reduction in strength of the knee extensors, ankle dorsiflexors and ankle plantar flexors. These findings were not confirmed in a more recent study by Lobet et al (2017) who found that children and adolescents with haemophilic arthropathy are functionally less disabled than structural evaluations would suggest, contrarily to adult patients, 8 who present progressive quadriceps weakness with increasing age stages, as compared to healthy individuals 9 . More recently, Lobet et al 10 studied the effect of structural joint damage on the elastic stiffness of the ankle in CwH and highlighted that the latter was significantly increased in children and adults with unilateral affected ankle joints compared to the non‐affected side.…”

Section: Introductionmentioning

confidence: 66%

Paediatric patients with blood‐induced ankle joint arthritis demonstrate physiological foot joint mechanics and energetics during walking

et al. 2020

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Aim: To compare foot joint kinetics and energetics in male paediatric boys with and without blood-induced ankle joint destruction to these of matched control groups. Methods: A cross-sectional study was conducted in which 3D gait analysis data were collected from thirty-five male children (6-21 years) with severe or moderate haemophilia and twenty-six typically developing boys. Structural integrity of the tarsal foot joints of all haemophilic patients was assessed using the IPSG-MRI scale. All participants walked barefoot while adopting a physiological gait pattern. Three subgroups were created based on the IPSG-MRI scores: a group with no joint involvement (HealthyHaemo), with uni-or bilaterally involvement (PathoHaemo) and with only unilaterally involvement (Haemo_Unilateral_Patho). Results: The PathoHaemo group presented a significant lower Lisfranc peak dorsiflexion angular velocity (34.7°/s vs 71.4°/s, P = .000, Cohen d = 1.31) and a significantly higher Lisfranc peak plantarflexion angular velocity (−130.5°/s vs −51.8°/s, P = .000, Cohen d = 0.98) compared to the control group. The Haemo_Unilateral_Patho side had a significant higher Chopart peak dorsiflexion angular velocity compared to the Haemo_Unilateral_Healthy side (41.7°/s vs 31.9°/s, P = .002, Cohen d = 1.16). Conclusion: No evidence for mild and severe gait deviations could be demonstrated. Internal moments, used as a surrogate measure of joint loading, quantified by the multi-segment foot model were found to be similar within the three subanalyses. We suggest that the ongoing musculoskeletal development in children compensates for structural damage to the ankle joint.

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“…Data were gathered on 163 patients with haemophilia over the age of 16 who had presented to the Coagulopathies Department of our Hospital for a routine musculoskeletal assessment between 2012 and 2017. Children were excluded given their high prevalence of congenital pes planovalgus and because they tend to be less prone to functional impairment . An evaluation was conducted of the patients’ social and demographic characteristics, including age, type of haemophilia, severity of disease, presence of inhibitors and haematologic treatment regimen (prophylactic or on demand).…”

Section: Methodsmentioning

confidence: 99%

Hindfoot malalignment in adults with haemophilic ankle arthropathy: The importance of early detection and orthotic treatment

et al. 2019

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Introduction Haemophilic arthropathy (osteoarthritis secondary to haemophilia) of the ankle may result in painful hindfoot malalignment. Purpose To analyse hindfoot alignment in subjects with haemophilic arthropathy of the ankle and evaluate the response (improvement of pain, function and alignment) to the orthotic treatment prescribed in patients with malalignment. Methods The study included 163 patients with haemophilia, all of them over 16 years of age. Hindfoot alignment and footprint were analysed in patients with and without haemophilic arthropathy of the ankle (as determined by the Pettersson score). Response to the use of an orthosis was evaluated at 6 months by means of the AOFAS Ankle‐Hindfoot Scale. Results Fifty‐six (59.5%) patients with haemophilic arthropathy presented with concomitant hindfoot malalignment. The most common abnormality was a valgus alignment combined with a neutral footprint. In 14 cases, valgus was associated with a pes planus or a pes cavus. Only 5 patients without haemophilic arthropathy (7.2%) presented with some form of malalignment. The differences between the groups were statistically significant. The probability of having malalignment increased with the degree of arthropathy. Patients with haemophilic arthropathy and malalignment were treated with an orthosis, with insoles as the most commonly used alternative (86%). Such treatment significantly improved patients’ pain and function‐related scores on the AOFAS Ankle‐Hindfoot Scale. Conclusion Given the high rates of valgus malalignment in subjects with haemophilic arthropathy of the ankle, and the good response rates obtained following individualised orthotic treatment, it seems reasonable to routinely evaluate hindfoot alignment in this group of patients.

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Deficits of ankle muscle strength not found in children, adolescents and young adults with haemophilic ankle arthropathy

Abstract: Contrarily to adult patients, CAAwH with repeated ankle bleeding may be less impaired than current structural evaluations imply, with possibly a latency between the occurrence of structural and functional damage.

Cited by 6 publications

References 36 publications

Assessment of passive musculoarticular ankle stiffness in children, adolescents and young adults with haemophilic ankle arthropathy

Assessment of passive musculoarticular ankle stiffness in children, adolescents and young adults with haemophilic ankle arthropathy

Paediatric patients with blood‐induced ankle joint arthritis demonstrate physiological foot joint mechanics and energetics during walking

Hindfoot malalignment in adults with haemophilic ankle arthropathy: The importance of early detection and orthotic treatment

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