Truque-Díaz Carlos, Meroño-Gallut Javier, Molina-García Cristina, Cuesta-Barriuso Rubén, Pérez-Llanes Raúl
Faculty of Physiotherapy, Podiatry and Occupational Therapy, Catholic University San Antonio-UCAM, 30107 Murcia, Spain.
Tú. Bienestar 360°, Physiotherapy and Medical Center, 30730 San Javier, Spain.
Life (Basel). 2024 Aug 22;14(8):1051. doi: 10.3390/life14081051.
(1) Background: The recurrence of hemarthrosis in patients with hemophilia triggers a pathophysiological process of degenerative, progressive, and irreversible joint destruction. This hemophilic arthropathy is characterized by chronic pain, muscle atrophy, loss of mobility, and proprioceptive alterations. As the same joint undergoes repeated hemarthrosis, the function of the mechanical receptors deteriorates, causing a pathophysiological modulation and deterioration of the musculoskeletal system. The objective was to analyze the differences in stability and balance, as well as in ankle dorsal flexion, functionality, and muscle strength, between patients with bilateral hemophilic arthropathy and their healthy peers. (2) Methods: A cross-sectional descriptive case-control study was performed. Twenty-two participants were recruited: 10 adult patients with bilateral hemophilic arthropathy of the knee and ankle and 12 healthy subjects. The variables were balance (Rs Scan pressure platform), ankle dorsiflexion range of motion (Leg Motion), functionality (2-Minute Walk Test), and ankle dorsal strength (dynamometry). (3) Results: Statistically significant differences ( < 0.05) were found in the balance without visual support in the Max-Y variable (MD = 2.83; CI95%: 0.33;5.33; Effect size (d) = 0.67), ankle dorsiflexion (MD = 16.00; CI95%: 14.30; 20.0; d = 7.46), and strength of the ankle flexor muscles (MD = 128.50; CI95%: 92.50; 153.60; d = 2.76). (4) Conclusions: Ankle range of motion in dorsal flexion, functionality, and muscle strength in dorsal flexion is poorer in patients with bilateral lower limb hemophilic arthropathy than in their healthy peers. Patients with bilateral hemophilic ankle arthropathy have statistically poorer stability and balance without visual support than their healthy peers.
(1)背景:血友病患者关节积血的复发会引发退行性、进行性且不可逆的关节破坏的病理生理过程。这种血友病性关节病的特征为慢性疼痛、肌肉萎缩、活动能力丧失以及本体感觉改变。随着同一关节反复发生积血,机械感受器的功能会恶化,导致肌肉骨骼系统的病理生理调节和功能退化。目的是分析双侧血友病性关节病患者与其健康同龄人在稳定性和平衡、踝关节背屈、功能以及肌肉力量方面的差异。(2)方法:进行了一项横断面描述性病例对照研究。招募了22名参与者:10名患有双侧膝关节和踝关节血友病性关节病的成年患者以及12名健康受试者。变量包括平衡(Rs Scan压力平台)、踝关节背屈活动范围(腿部运动)、功能(2分钟步行测试)以及踝关节背侧力量(测力计测量)。(3)结果:在Max - Y变量的无视觉支持平衡方面(MD = 2.83;95%置信区间:0.33;5.33;效应量(d) = 0.67)、踝关节背屈方面(MD = 16.00;95%置信区间:14.30;20.0;d = 7.46)以及踝关节屈肌力量方面(MD = 128.50;95%置信区间:92.50;153.60;d = 2.76)发现了具有统计学意义的差异(P < 0.05)。(4)结论:双侧下肢血友病性关节病患者的踝关节背屈活动范围、功能以及背屈肌肉力量比其健康同龄人差。双侧血友病性踝关节病患者在无视觉支持时的稳定性和平衡在统计学上比其健康同龄人差。