Hemophilic Arthropathy of the Knee and Its Association with Reduced Muscle Strength and Activation and the Pressure Pain Threshold: A Case-Control Study

Abstract

(1) Background: Hemophilia is characterized by recurrent hemarthrosis leading to degenerative arthropathy. The aim was to evaluate the differences in muscle strength and activity and the pressure pain threshold between patients with knee arthropathy and their healthy peers; (2) Methods: A case-control study in which 23 adult patients with knee arthropathy and 24 healthy peers matched in terms of characteristics were recruited. The study variables were quadriceps muscle strength, muscle activation and the pressure pain threshold; (3) Results: There were significant differences between the two groups in quadriceps strength on the dominant (CI95%: 64.69, 129.2) and non-dominant (CI95%: 29.95, 93.55) sides and in the pressure pain threshold on the dominant (CI95%: 3.30, 43.54) and non-dominant (CI95%: 3.09, 45.25) sides. There were differences in neuromuscular fatigue on the non-dominant side in the vastus medialis (CI95%: 8.72, 21.51), vastus lateralis (CI95%: 4.84, 21.66) and rectus femoris (CI95%: 6.48, 24.95) muscles; (4) Conclusions: Muscle strength and the pressure pain threshold are lower in patients with hemophilia. Quadriceps muscle activation in patients with hemophilic knee arthropathy does not in any way differ from activation in healthy subjects. However, muscle fatigue is greater in patients with knee arthropathy. Strength training in patients with hemophilia should focus on the activation of the vastus medialis and lateralis muscles.

Functional clinical motor performance tests to assess potential fall risks in patients with haemophilia: A case‐control study

“…This study aimed to provide information on objective functional mobil- .005 Results of the study presented herein also reveal a lower knee extension strength of both legs and a lower handgrip strength of both hands in PwH, supporting previous studies. 7,23,24 Besides, the SPPB function declines, which was also previously described for PwH. 27 Indeed, a vicious circle might occur as it is known that subjective physical performance negatively correlates with kinesiophobia, 28,29 which is also observed in the study presented herein (r s = −0.483).…”

“…*p < .05 versus CG; **p < .01 versus CG; ***p < .001 versus CG; # p < .05 versus minorly affected, ## p < .01 versus minorly affected, ### p < .001 versus minorly affected.healthy controls (396 and 429 Newton, respectively) show significantly higher strength values. Along with lower strength in PwH it was recently shown that muscle fatigue (based on electromyography analyses) is greater in PwH with knee arthropathy in response to isometric exercises23 and that PwH show impaired neuromuscular control during gait 25. This might be one explanation for the observed impairmentsin leg-and hand-strength as well as the five times chair rise test in PwH but also in other basic everyday functional mobility tests conducted in this study.…”

A qualitative study on the perioperative experiences and demands of haemophilic arthropathy patients undergoing total joint replacement

“…2 People with severe haemophilic arthropathy (PWHA) usually suffer from joint deformity, subluxations, stiffness and eventual disability due to loss of joint function. 3 Total joint replacement (TJR) can largely restore joint function and has become a reliable treatment for PWHA. 4,5 Despite advancements in surgical techniques, studies indicate that 10%-20% 6,7 of patients are dissatisfied with surgical outcomes.…”