Posturographic analysis of balance control in patients with haemophilic arthropathy

Abstract

Musculoskeletal disorders in haemophiliacs represent the highest percentage of lesions, giving rise to haemophilic arthropathy (HA) which predominantly affects lower limbs, influencing postural control, standing and walking. Leading a sedentary lifestyle seems to influence strength and muscular resistance in haemophiliacs which, in turn, are related to articular stability and the prevention of articular degenerative processes. The objective of this work was to study alterations in balance to subsequently evaluate the appropriate therapeutics and how this influences the development of arthropathy. Twenty-five haemophiliacs with HA, 25 haemophiliacs without HA (NHA) and 25 healthy control subjects (CTL) took part in this study. Tests were performed on a force platform and the subjects remained as still as possible for 30 s under different conditions: (i) bilateral stance with eyes open; (ii) bilateral stance with eyes closed; (iii) right unilateral stance; and (iv) left unilateral stance. The results of these tests indicated significant differences (P < 0.05) between the groups HA, NHA and CTL. The HA group presented worse results for both unilateral and bilateral stance when compared with the other two cohorts. Surprisingly, the NHA group displayed a worse balance than the controls. A single calculated parameter (mean frequency) did not show significant differences. This apparently indicates the absence of pathology in the nervous system in relation to postural control. The results suggest that our patients should participate in physical exercise programmes, rehabilitation and physiotherapy to improve their postural control.

Hemofilia: ejercicio y deporte

“…Actualmente podemos decir que, en general, la condición física del paciente hemofílico adulto es baja, ya que hay estudios que muestran valores inferiores de resistencia aeróbica 49 , fuerza 37,50,51 , propiocepción y equilibrio 50,52,53 , respecto a los encontrados en sus pares sanos.…”

Postural Stability Is Affected in Older Males with Haemophilia—A Matched Control Study

“…Measurement of postural sway, the horizontal movement of the body around the centre of gravity, is commonly used to evaluate postural stability, and disturbance of input from the sensory systems will affect postural sway [16][17][18][19][20][21]. Studies of postural sway in young adults also suggest that fatigue of the hip and ankle muscles increases postural sway [16,17].…”

“…Gallach et al [21] compared standing balance in a group of 50 adult PWH and 25 age-matched healthy non-haemophilic men and observed greater amplitude and velocity of postural sway in men with haemophilia during standing. In a study of twenty PWH aged 22-58 years, Fearn et al [22] reported that half of haemophilic men had experienced a fall within the previous 12 months.…”

Influence of Sensorimotor Training on Balance and Pain Parameters in Children With Hemophilia

“…Results showed that patients with hemophilia displayed a worse balance and proprioception compared with healthy normal subjects [10][11][12][13].Authors hypothesized that because proprioception information is transmitted from receptors found in all tissues of the synovial joint, repeated joint bleeding into the target joint could be a contributory cause of impaired proprioception in patients with hemophilia. As the muscular function comprises not only the static control of the joint and the dynamic control of movement, but also the proprioceptive input to the central nervous system (CNS) .So further possible mechanism induced proprioception deficit in hemophilic patients may be related to the intramuscular bleeding and lower muscle strength [14,15].…”