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新冠疫情封锁后血友病患者的肌肉骨骼变化

Musculoskeletal Changes in Hemophilia Patients Subsequent to COVID-19 Lockdown.

作者信息

Cuesta-Barriuso Rubén, Meroño-Gallut Javier, Pérez-Llanes Raúl, Ucero-Lozano Roberto

机构信息

Department of Physiotherapy, University of Murcia, 30100 Murcia, Spain.

Royal Victoria Eugenia Foundation, 28029 Madrid, Spain.

出版信息

Healthcare (Basel). 2021 Jun 9;9(6):702. doi: 10.3390/healthcare9060702.

Abstract

(1) Background. The lockdown period due to the COVID-19 pandemic has drastically decreased levels of physical activity in the population. Hemophilia is characterized by hemarthrosis that leads to chronic, progressive and degenerative joint deterioration. (2) Methods. This observational study recruited 27 patients with hemophilia and arthropathy. Knee, ankle and elbow joints were assessed. The frequency of clinical hemarthrosis, pain intensity, pressure pain threshold, and joint ROM were evaluated. (3) Results. Following lockdown, a significant deterioration of joint condition, perceived joint pain and range of motion was noted in all joints. There were no changes in the frequency of knee hemarthrosis, while the frequency of ankle hemarthrosis significantly reduced. However, the frequency of elbow hemarthrosis increased. Depending on the degree of hemophilia severity, there were changes in pressure pain threshold in the elbow and in pain intensity and range of motion of the ankle joint. According to the type of treatment, i.e., prophylaxis vs. on-demand treatment, there were differences in the joint condition in elbows and the plantar flexion movement of the ankle. There were no differences in the knee joint based on the severity of the disease, the type of treatment or the development of inhibitors (4). Conclusions. Because of the COVID-19 lockdown, the musculoskeletal status of patients with hemophilia deteriorated. Joint condition, perceived pain, and range of motion were significantly affected. The frequency of clinical hemarthrosis did not increase during this period. A more active therapeutic model could prevent rapid deterioration in patients with hemophilic arthropathy during prolonged sedentary periods.

摘要

(1) 背景。由于新冠疫情实施的封锁措施大幅降低了人群的身体活动水平。血友病的特征是关节积血,可导致慢性、进行性和退行性关节病变。(2) 方法。这项观察性研究招募了27例患有血友病和关节病的患者。对膝关节、踝关节和肘关节进行了评估。评估了临床关节积血的频率、疼痛强度、压痛阈值和关节活动度。(3) 结果。封锁之后,所有关节的关节状况、自觉关节疼痛和活动范围均出现显著恶化。膝关节积血频率无变化,而踝关节积血频率显著降低。然而,肘关节积血频率增加。根据血友病严重程度,肘关节压痛阈值以及踝关节疼痛强度和活动范围出现了变化。根据治疗类型,即预防治疗与按需治疗,肘关节的关节状况和踝关节的跖屈运动存在差异。基于疾病严重程度、治疗类型或抑制剂的产生情况,膝关节未出现差异。(4) 结论。由于新冠疫情封锁,血友病患者的肌肉骨骼状况恶化。关节状况、自觉疼痛和活动范围均受到显著影响。在此期间,临床关节积血频率未增加。一种更积极的治疗模式可以防止血友病性关节病患者在长期久坐期间迅速恶化。

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