Bicycle ergometer versus treadmill on balance and gait parameters in children with hemophilia

Abstract

Background and purpose: Children with hemophilia often bleed inside the joints and muscles, which may impair postural adjustments. These postural adjustments are necessary to control gait and postural balance during daily activities. The inability to quickly recover postural balance could elevate the risk of bleeding.So, the purpose of this study was to compare between the effects of bicycle ergometer and treadmill on balance and gait parameters in children with hemophilia.Materials and methods: Thirty hemophilic boys with the ages ranging from 10 to 14 years had participated in this study. They were assigned randomly into two equal study groups. Group A received a designed physical therapy program and aerobic exercise training by bicycle ergometer. While group B received the same physical therapy program in addition to aerobic exercise training by the treadmill. Both groups received treatment sessions three times per week for three successive months. Stability indices and kinematic gait parameters were evaluated before and after three successive months of treatment.Results: There were non significant differences between the pre-treatment mean values of all measuring variables for the two groups. Significant improvement was observed in the two groups when comparing their pre and post treatment mean values. Also, significant differences were recorded when comparing the post treatment results of the two groups in favor of the study group B.Conclusion: Aerobic exercise, in the form of treadmill training for children with hemophilia, is an excellent supplement to regularly scheduled physical therapy intervention. It improves the degree of stability and gait parameters for those patients. Ó 2014 Production and hosting by Elsevier B.V. on behalf of Ain Shams University.

Effectiveness of Physiotherapy in the Treatment of Hemophilic Arthropathy a Systematic Review

“…In a first phase, after discarding the 116 articles repeated among the various documentary sources, the titles and abstract of the remaining 67 studies were analyzed. Finally, following the selection process, only 10 articles [19][20][21][22][23][24][25][26][27][28] met the established criteria. Figure 1 shows the flow diagram with the selection made according to the criteria described above.…”

“…Also noteworthy is the intervention based on balance, gait and ergonomic bicycle isometric exercises, carried out by Eid, et al [24] and Mohamed, et al [25].…”

“…The development of home exercise programs and ergonomic bicycle and treadmill exercises to develop muscle strength, gait and proprioception were the most used therapeutic tools in the studies analyzed in the present review [19][20][21]24,25,27,28]. Joint traction (level I-II) and active and passive kinesitherapy are also used in the approach of hemophilic arthropathy [22,23].…”

“…Blinding of the therapist and the patient or rater are the only items in which these articles did not achieve a positive score. On the other hand, two articles scored 8 points [22,25], the failure to describe the method of randomization being the main methodological deficiency. Three studies [20,21,24] scored 7 points, while one article scored 6 points [19], and only one [27] 5 points.…”

“…Similarly, five articles [20][21][22][23]25] scored 6 points out of 9, mainly as a result from not describing the method of randomization and comparison between groups. Finally, two articles [19,24] scored 5 points, the main methodological deficiencies being blinding and randomization, while another article only reached a score of 4 points [27].…”