Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile.
Research, Innovation, and Development Section in Kinesiology, Kinesiology Unit, San José Hospital, Santiago, Chile.
Haemophilia. 2024 Jul;30(4):1010-1017. doi: 10.1111/hae.15021. Epub 2024 May 7.
Regular assessment of motor impairments is crucial in people with haemophilic arthropathy (PwHA). This study aimed to determine if there are differences in 30-seconds sit-to-stand (30-STS) power and maximal voluntary isometric contraction (MVIC) of the knee extensors between PwHA and healthy control group (CG). The secondary aims were to investigate the correlation between 30-STS power and MVIC of knee extensors with clinical characteristics and to assess their effectiveness in identifying motor impairment in PwHA.
A cross-sectional study was conducted by collecting data from PwHA (n = 17) and a sedentary CG (n = 15). MVIC (torque) and 30-STS power were normalised to body mass. Correlation analysis and simple linear regression adjusted for age were used to assess the association between tests and clinical variables. Using z-scores derived from the mean and standard deviation of the CG, we compared the MVIC and the 30-STS power in PwHA.
PwHA showed lower MVIC and 30-STS power compared to CG (p < .001; large effect size d > .8). Lower 30-STS power was associated with greater joint impairment and greater fear of movement, whereas MVIC showed no association with clinical variables. 30-STS power showed a lower z-score compared to MVIC (p < .001). In addition, 30-STS power detected 47% of PwHA with motor impairment compared to 0% for MVIC (p = .002).
Our results suggest that 30-STS power may be more effective than knee extensors MVIC in detecting motor impairment in PwHA. Consequently, lower limb skeletal muscle power, rather than maximum knee extensor strength, appears to be more affected in PwHA.
定期评估血友病性关节病（PwHA）患者的运动障碍至关重要。本研究旨在确定 PwHA 与健康对照组（CG）之间 30 秒坐-站（30-STS）力量和最大自主等长收缩（MVIC）的膝关节伸肌是否存在差异。次要目的是探讨 30-STS 力量与膝关节伸肌 MVIC 与临床特征的相关性，并评估其在识别 PwHA 运动障碍中的有效性。
通过收集 PwHA（n=17）和久坐 CG（n=15）的数据进行横断面研究。MVIC（扭矩）和 30-STS 力量按体重归一化。使用年龄调整的相关分析和简单线性回归来评估测试与临床变量之间的相关性。使用 CG 的平均值和标准差得出的 z 分数，我们比较了 PwHA 中的 MVIC 和 30-STS 力量。
与 CG 相比，PwHA 的 MVIC 和 30-STS 力量较低（p<.001；大效应量 d>.8）。较低的 30-STS 力量与更大的关节损伤和更大的运动恐惧相关，而 MVIC 与临床变量无关。与 MVIC 相比，30-STS 力量的 z 分数较低（p<.001）。此外，与 MVIC 相比，30-STS 力量检测到 47%的 PwHA 存在运动障碍，而 MVIC 为 0%（p=.002）。
我们的结果表明，30-STS 力量可能比膝关节伸肌 MVIC 更有效地检测 PwHA 的运动障碍。因此，下肢骨骼肌力量而不是最大膝关节伸肌力量似乎在 PwHA 中受到的影响更大。
