Physical Therapy, Communication Disorders and Occupational Therapy, University of São Paulo, São Paulo, Brazil.
Haemophilia. 2013 Jul;19(4):e212-7. doi: 10.1111/hae.12106. Epub 2013 Mar 28.
Sensory information from visual, vestibular and proprioceptive systems is necessary to control posture and balance. Impairment in proprioception due to repetitive joints bleeding may lead to a deficit in postural balance which, in turn, leads to high joint stress and risk of bleeding recurrence. Despite the increase in attention in this field during the past few years, the data concerning to how bleeds can affect postural control in children with haemophilia (CWH) remain scarce. This study aimed to evaluate the postural balance in CWH. Twenty CWH Haemophilia Group (HG) and 20 age-matched children Control Group (CG) were recruited to this study. A force plate was used to record centre of pressure (COP) displacement under four different postural conditions during quiet standing: eyes open on firm surface, eyes open on foam surface, eyes closed on firm surface and eyes closed on a foam surface. Variables of COP as sway area and mean velocity and in anterior-posterior (y) medio-lateral (x) direction were processed and for each variable sensory, quotients were calculated and compared between groups. No differences were found in visual and vestibular quotients variables between groups. A higher value was found in sway area variable on proprioception quotient in the HG when compared with CG (P = 0.042). CWH with repetitive joint bleed on lower limbs showed differences in postural balance when compared with non-haemophiliac children. The identification of early balance impairments in CWH can help us understand better the effects of bleeds inside joints on postural control and plan a more effective preventive and rehabilitative treatment.
视觉、前庭和本体感觉系统的感觉信息对于控制姿势和平衡是必要的。由于重复关节出血导致本体感觉受损，可能导致姿势平衡缺陷，进而导致关节高应力和再次出血的风险增加。尽管在过去几年中，人们对这一领域的关注度有所提高，但关于出血如何影响血友病儿童（CWH）的姿势控制的数据仍然很少。本研究旨在评估 CWH 的姿势平衡。招募了 20 名 CWH 血友病组（HG）和 20 名年龄匹配的对照组（CG）儿童参加本研究。使用测力板记录在安静站立时的四个不同姿势条件下的中心压力（COP）位移：睁眼在坚固表面、睁眼在泡沫表面、闭眼在坚固表面和闭眼在泡沫表面。对 COP 的变量（如摇摆面积和平均速度以及前后（y）方向和左右（x）方向）进行处理，并对每个变量的感觉进行处理，计算并比较组间的比值。组间在视觉和前庭比值变量方面没有差异。与 CG 相比，HG 中本体感觉比值的摇摆面积变量值更高（P=0.042）。与非血友病儿童相比，下肢有反复关节出血的 CWH 其姿势平衡存在差异。识别 CWH 早期平衡障碍可以帮助我们更好地理解关节内出血对姿势控制的影响，并计划更有效的预防和康复治疗。
