Journals / Turkish Journal of Pediatrics / 2020 / Cilt: 62 - Sayı: 4

Muscle strength and joint health in children with hemophilia: a cross-sectional study

Pages
606–613
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Our findings indicate that hemarthrosis may cause more muscle strength loss in the upper extremity than the lower extremity.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Background and objectives.
📊
Key Findings & Data:Forty-one CwH aged between 6-18 years participated in the study.
💡
Conclusion & Impact:Our findings indicate that hemarthrosis may cause more muscle strength loss in the upper extremity than the lower extremity.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Özet

Background and objectives. We aimed to evaluate joint health in children with hemophilia (CwH) and to investigate the effects of hemarthrosis on the musculoskeletal system. Method. Forty-one CwH aged between 6-18 years participated in the study. Joint health status was evaluated according to Hemophilia Joint Health Score (HJHS). Pain intensity level was assessed in resting and in activity using Visual Analog Scale. Range of motion was measured with goniometer and muscle strength was assessed with digital dynamometer. Arthropathic joints were examined in three groups named knee, elbow and ankle. Results. Physical examination revealed arthropathy findings to be found in 29 knee, 19 elbow and 18 ankle joints. The median of flexion angle of the affected side were 120°, 122° and 12° for the knee, elbow and ankle and extension losses of these joints were 5°, 7° and 0, respectively. In CwH having knee and elbow arthropathy, index joint HJHS was found to be significantly higher than those with ankle arthropathy (p <0.01). The flexor and extensor muscle strength significantly decreased in 11 CwH with unilateral elbow arthropathy compared to the non-arthropatic side (p <0.05). In 15 CwH with unilateral ankle arthropathy decreased in the extensor muscle strength (plantarflexors) (p <0.05). Extension loss showed a good correlation with index HJHS of elbow, knee and ankle joints, respectively. (rs = 0.599, 0.576, 0.606, p <0.01). We observed that the muscle strength of elbow flexors/extensors and ankle extensors were significantly decreased compared to the non-arthropathic side. However this situation was not detected in knee joint despite having highest index HJHS. Conclusion. Our findings indicate that hemarthrosis may cause more muscle strength loss in the upper extremity than the lower extremity. Furthermore, extension loss was found to be an important parameter in physical examination of hemophilic arthropathy. Musculoskeletal system should be evaluated comprehensively at regular intervals and when necessary rehabilitative treatment should be planned.

🔖

Cite This Article

TAT, N. M., TAT, A. M., CAN, F., ÖNER, A. F. (2020). Muscle strength and joint health in children with hemophilia: a cross-sectional study. Turkish Journal of Pediatrics, Cilt: 62 - Sayı: 4, 606–613. https://ajindex.com/articles/411835

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (14)

  1. Srivastava A, Brewer AK, Mauser-Bunschoten EP, et al; Treatment Guidelines Working Group on behalf of the World Federation of Hemophilia. Guidelines for the management of hemophilia. Haemophilia 2013; 19: e1-e47
  2. Lobet S, Hermans C, Lambert C. Optimal management of hemophilic arthropathy and hematomas. J Blood Med 2014; 5: 207-218
  3. White 2nd G, Rosendaal F, Aledort LM, Lusher JM, Rothschild C, Ingerslev J; Factor VIII and Factor IX Subcommittee. Definitions in Hemophilia. Recommendation of the scientific subcommittee on factor VIII and factor IX of the scientific and standardization committee of the International Society on Thrombosis and Haemostasis. Thromb Haemost 2001; 85: 560
  4. Franchini M, Mannucci PM. Past, present and future of hemophilia: a narrative review. Orphanet J Rare Dis 2012; 7: 24
  5. Rodríguez-Merchán EC. Effects of hemophilia on articulations of children and adults. Clin Orthop Relat Res 1996; 328: 7-13
  6. Rodriguez-Merchan EC, Jimenez-Yuste V, Aznar JA et al. Joint protection in haemophilia. Haemophilia 2011; 17(Suppl 2): 1-23
  7. Carcao M, Hilliard P, Escobar MA, Solimeno L, Mahlangu J, Santagostino E. Optimising musculoskeletal care for patients with haemophilia. Eur J Haematol 2015; 95(Suppl 81): 11-21
  8. Stephensen D, Bladen M, McLaughlin P. Recent advances in musculoskeletal physiotherapy for haemophilia. Ther Adv Hematol 2018; 9: 227-237
  9. Feldman BM, Funk SM, Bergstrom BM, et al. Validation of a new pediatric joint scoring system from the International Hemophilia Prophylaxis Study Group: validity of the hemophilia joint health score. Arthritis Care Res (Hoboken) 2011; 63: 223- 230
  10. Feldman BM, Funk S, Lundin B, Doria AS, Ljung R, Blanchette V; International Prophylaxis Study Group (IPSG). Musculoskeletal measurement tools from the International Prophylaxis Study Group (IPSG). Haemophilia 2008; 14(Suppl 3): 162-169
  11. Poonnoose PM, Srivastava A. Functional assessment of arthropathy-an international perspective. Semin Hematol 2006; 43(Suppl 1): S27-S32. 12. de Moerloose P, Fischer K, Lambert T, et al. Recommendations for assessment, monitoring and follow-up of patients with haemophilia. Haemophilia 2012; 18: 319-325
  12. Stephensen D, Tait RC, Brodie N, et al. Changing patterns of bleeding in patients with severe haemophilia A. Haemophilia 2009; 15: 1210-1214
  13. Norkin CC, White DJ. Measurement of Joint Motion: A Guide to Goniometry. (4th ed). Philadelphia: FA Davis Company, 2009
  14. Cuesta-Barriuso R, Gómez