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

Abstract

Despite fall-related injuries having serious consequences for older haemophilic patients, few studies have investigated their postural stability and risk of falls. The aim was to examine postural stability, joint function and joint mobility in haemophiliacs and age-matched controls. Centre of pressure excursions in four 60 s balance conditions, two minute walk test, passive ankle and knee range of motion, Haemophilia Joint Health Score, and Haemophilia Early Arthropathy Detection with Ultrasound score were measured in eight men with haemophilia (people with heamophilia, PWH), and eight age-matched men without haemophilia (people without heamophilia, PWOH). . Joint function, mobility, and postural stability are reduced in PWH compared to PWOH, driven by differences in the CoP AP range. Dynamic tests incorporating physical perturbation may be more effective than static balance tests on a level surface, and longer period of time to assess postural stability may determine whether fatigue affects ability of PWH to maintain postural stability. Adoption of a possible 'hip strategy' by which to achieve balance suggests falls prevention programs need to focus on increasing hip strength and retraining ankle strategy movement to allow PWH to improve balance stability.

Static postural balance evaluation and an investigation of the relationship with joint health in children with severe haemophilia: a controlled cross‐sectional study

“…In the balance studies so far in haemophilia, a short test period of 15–20 seconds has been preferred 2,11 and clinical evaluation of balance has been investigated more frequently with Functional Reach, Step and Timed Up‐Go Tests 7,8 . In the study in which a test time similar to our study was used (60‐second test time), Digby‐Bowl et al found deterioration in postural stability in AwH under perturbated conditions 10 . The relationship between postural balance and joint health has been relatively less‐explored 11,13 …”

“…Although the perimeter and EA in CwH was larger than healthy peers, there was no significant difference. Digby‐Bowl et al reported that the ellipse area, perimeter and both displacements (APD and MLD) were not different in AwH in both BEO and BEC condition compared to healthy controls, but all values were higher on perturbated conditions 10 . In a study conducted by Souza et al, they reported that the sway area of CwHs’ differ only in proprioception quotient compared to healthy controls 2 .…”

“…5 A relationship between the degree of joint damage and proprioceptive disorder is observed in haemophilic patients. 6 Postural balance disturbances have been shown in both adult with haemophilia (AwH) [7][8][9][10] and children with haemophilia (CwH), 2,3,[11][12][13] but it is contradictory with which parameter this is associated. This contradiction may be due to a lack of study in the literature evaluating all balance parameters as an integrated system.…”

“…7,8 In the study in which a test time similar to our study was used (60-second test time), Digby-Bowl et al found deterioration in postural stability in AwH under perturbated conditions. 10 The relationship between postural balance and joint health has been relatively less-explored. 11,13 The aim of the present study was to investigate the possible changes in static postural balance parameters with more integrated and comprehensive way using longer test duration and to reveal the relationship with joint health score in CwH.…”

Identifying performance‐based outcome measures of physical function in people with haemophilia (IPOP)

“…In Recent studies in persons with haemophilia suggest some of these tests; one leg balance, [25][26][27][28][29][30][31][32] 6-min walk test, 26,30,[33][34][35][36][37] timed up and down stairs 30,34 and timed up and go [38][39][40][41][42][43][44][45][46] may be responsive for monitoring physical function in people with haemophilia. However, confirmation of psychometric properties in people with haemophilia, such as test-retest repeatability, validity and minimal clinical important differences are required before recommendations can be made about longitudinal clinical use for all ages.…”