Postural stability is affected in older males with Haemophilia—a matched control study

Journal article

Digby-Bowl, C., Brown, M. and Stephensen, D. 2018. Postural stability is affected in older males with Haemophilia—a matched control study. Journal of Functional Morphology and Kinesiology. 3 (1), pp. 10-20. https://doi.org/10.3390/jfmk3010010
AuthorsDigby-Bowl, C., Brown, M. and Stephensen, D.
Abstract

Despite fall-related injuries having serious consequences for older haemophilic patients, few studies have investigated their postural stability and risk of falls.

The aim was to examine postural stability, joint function and joint mobility in haemophiliacs and age-matched controls. Centre of pressure excursions in four 60 s balance conditions, two minute walk test, passive ankle and knee range of motion, Haemophilia Joint Health Score, and Haemophilia Early Arthropathy Detection with Ultrasound score were measured in eight men with haemophilia (people with heamophilia, PWH), and eight age-matched men without haemophilia (people without heamophilia, PWOH). PWH have significantly worse postural stability under physically perturbed conditions (p = 0.001–0.028, η2p
= 0.19–0.34), reduced joint function (p = 0.001–0.010, d = 1.33–2.62) and mobility (p < 0.001–0.025, d = 1.01–4.61), and increased centre of pressure (CoP) velocity (p < 0.001–0.003) when compared to PWOH. Postural stability among PWH did not deteriorate with time standing, although significant decreases compared to PWOH across all time intervals were observed (Eyes Open Foam (EOF) CoP ellipse (time x group) p = 0.011, η2p
= 0.28; path (time × group) p = 0.035, η2p
= 0.21; EOF CoP antero-posterior (AP) (time × group) p = 0.021, η2p
= 0.24). Joint function, mobility, and postural stability are reduced in PWH compared to PWOH, driven by differences in the CoP AP range. Dynamic tests incorporating physical perturbation may be more effective than static balance tests on a level surface, and longer period of time to assess postural stability may determine whether fatigue affects ability of PWH to maintain postural stability. Adoption of a possible ‘hip strategy’ by which to achieve balance suggests falls prevention programs need to focus on increasing hip strength and retraining ankle strategy movement to allow PWH to improve balance stability.

KeywordsBalance; haemophilia; mobility; falls; postural stability
Year2018
JournalJournal of Functional Morphology and Kinesiology
Journal citation3 (1), pp. 10-20
PublisherMDPI
ISSN2411-5142
Digital Object Identifier (DOI)https://doi.org/10.3390/jfmk3010010
Related URLhttp://www.mdpi.com/journal/jfmk
Publication dates
Print31 Jan 2018
Publication process dates
Deposited31 Jan 2018
Accepted19 Jan 2018
Publisher's version
Output statusPublished
References

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Uphill, M., Balsdon, A., Brown, M., Digby-Bowl, C., Southam, M. and Swain, J. 2015. "Hero Imagery" - Are there performance advantages associated with imagining yourself as your favourite athlete?
Exploring the significance of falls in the everyday lives of the older person with haemophilia
Stephensen, D., Brown, M., Digby-Bowl, C., Swaine, I. and Evans, G. 2016. Exploring the significance of falls in the everyday lives of the older person with haemophilia. Haemophilia. 22 (S2), pp. 45-46. https://doi.org/10.1111/hae.1_12882
Clinical outcome measures for monitoring physical function in pediatric obesity: An integrative review
Mahaffey, R., Morrison, S.C., Stephensen, D. and Drechsler, W.I. 2016. Clinical outcome measures for monitoring physical function in pediatric obesity: An integrative review. Obesity. 24 (5), pp. 993-1017. https://doi.org/10.1002/oby.21468
A laboratory and field comparison of gross efficiency at an absolute, relative and performance intensity
Saunders, S., Brown, M. and Coleman, D. 2014. A laboratory and field comparison of gross efficiency at an absolute, relative and performance intensity.
The relationship between cycle tourism and sustainable transport in the UK
Weed, M., Bull, C., Brown, M., Dowse, S., Lovell, J., Mansfield, L. and Wellard, I. 2014. The relationship between cycle tourism and sustainable transport in the UK. Tourism Review International. https://doi.org/10.3727/154427214X13990420684644
The effect of short-term calorie restriction on exercise performance and efficiency in cyclists
Saunders, S., Coleman, D. and Brown, M. 2013. The effect of short-term calorie restriction on exercise performance and efficiency in cyclists.
Activation and contribution of trunk and leg musculature to force production during on-water sprint kayak performance
Brown, M., Lauder, M. and Dyson, R. 2010. Activation and contribution of trunk and leg musculature to force production during on-water sprint kayak performance.
Non-invasive measurement of tibial rotation during the impact phase of running
Digby-Bowl, C., Lake, M. and Lees, A. 2003. Non-invasive measurement of tibial rotation during the impact phase of running.
High-speed, non-invasive measurement of tibial rotation during the impact phase of running
Digby-Bowl, C., Lake, M. and Lees, A. 2003. High-speed, non-invasive measurement of tibial rotation during the impact phase of running.
Using arch height and flexibility to characterise foot type
Digby-Bowl, C. and Lake, M. 2004. Using arch height and flexibility to characterise foot type.
Relationships between static and dynamic indicators of foot type and the movement coupling
Digby-Bowl, C. and Lake, M. 2005. Relationships between static and dynamic indicators of foot type and the movement coupling.
High-speed coupling characteristics of the foot type and shank during the stance phase of running
Digby-Bowl, C., Lake, M. and Lees, A. 2005. High-speed coupling characteristics of the foot type and shank during the stance phase of running.
A preliminary assessment of the effects of foot type on the movement coupling of the foot and shank during the stance phase of barefoot running
Digby-Bowl, C., Lake, M. and Lees, A. 2005. A preliminary assessment of the effects of foot type on the movement coupling of the foot and shank during the stance phase of barefoot running.
Using pressure and high-speed kinematic data to assess foot-to-shank movement coupling during running
Digby-Bowl, C., Lake, M. and Lens, T. 2005. Using pressure and high-speed kinematic data to assess foot-to-shank movement coupling during running.