Pedobarographic and stabilometric analysis and exercises for children with recurrent ankle haemarthrosis

Abstract

Background/Aims: To investigate the dynamic plantar loading characteristics, postural stability and the effectiveness of an exercise programme in children with recurrent ankle haemarthrosis. Methods: In an exploratory study, 56 children with haemophilia (Group A) and 23 typically developing children (Group B) were initially assessed. Group A received a progressive exercise programme twice a week for 6 weeks in succession. Midstance plantar loading and the dynamic limit of stability were measured using Tekscan HR MatTM pressure measurement system and Biodex Balance System respectively. Findings: Heel pressure in Group A was significantly lower than Group B (P<0.05), whereas mid-foot, forefoot, and hallux pressure were significantly higher (P<0.05). Also, Group A showed poorer postural stability (P<0.05). Furthermore, a significant correlation between postural stability and plantar loading measures was indicated in Group A. Following the completion of 6 weeks of exercises, the plantar pressure (except the medial mid-foot) and postural stability (except the mediolateral stability) for Group A were not significantly different in comparison to Group B (P>0.05). Conclusion: Dynamic plantar loading provides a potentially valuable directory for the clinicians to understand variations of postural stability in children with ankle haemarthrosis. Further, adherence to a 6-week exercise rehabilitation programme might be helpful.

Effectiveness of physical exercise on postural balance in patients with haemophilia: A systematic review

“…A total of 304 PWH were included. Of these, 44.08% were children (aged 9-13) 30,33,36,37 and 55.92% were adults (aged 32-59). 28,29,31,32,34,35 The number of participants per study ranged from 8 30 to 52.…”

“…Three studies performed the intervention three sessions per week 30,33,36 and four studies in 2 sessions/week. 28,31,34,37 One study encouraged the participants to exercise on all days for 8 weeks, 32 with another doing five sessions per week for 16 weeks. 29 Only one study did not state the session frequency.…”

“…29 Only one study did not state the session frequency. 35 In all of the interventions, strength and balance were trained; 5 studies incorporated flexibility; 28,30,32,33,35 two studies include mobilization exercises 34,36 and one study included flexibility and mobilization exercises; 37 three studies contain gait training exercises 29,33,36 and in another, aerobic exercises were included. 33 One study compared an exercise program with another physiotherapy intervention, specifically home exercising with a self-monitoring program (feedback and activity monitor) versus home exercising without an activity monitor.…”

“…33 Three studies compared an exercises program versus a control group (normal life). 31,34,37 One study compared an exercise program in a intervention group of PWH with two control groups: 28 PWH and healthy subjects. Three studies analyzed the effect of an exercise program in PWH without a control group (Table 2).…”

“…25 The majority of the studies [32][33][34]37 had a fair quality rate of risk of bias; two 28,31 had a poor quality rate and one 36 had a good quality rate. Three out of seven 28,32,37 did not report whether the study was randomized or not. Only three studies [32][33][34] had an adequate method of randomization and simply one study had a good allocation concealment.…”