Postural Stability Is Affected in Older Males with Haemophilia—A Matched Control Study
Section of Sport and Exercise Sciences, Canterbury Christ Church University, North Holmes Road, Canterbury, Kent CT1 1QU, UK
Kent Haemophilia Centre, Kent and Canterbury Hospital, Canterbury, Kent CT1 3NG, UK
Author to whom correspondence should be addressed.
Received: 12 December 2017 / Revised: 12 January 2018 / Accepted: 19 January 2018 / Published: 31 January 2018
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
= 0.19–0.34), 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
= 0.28; path (time × group) p
= 0.21; EOF CoP antero-posterior (AP) (time × group) p
= 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.
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MDPI and ACS Style
Digby-Bowl, C.J.; Brown, M.B.; Stephensen, D. Postural Stability Is Affected in Older Males with Haemophilia—A Matched Control Study. J. Funct. Morphol. Kinesiol. 2018, 3, 10.
Digby-Bowl CJ, Brown MB, Stephensen D. Postural Stability Is Affected in Older Males with Haemophilia—A Matched Control Study. Journal of Functional Morphology and Kinesiology. 2018; 3(1):10.
Digby-Bowl, Caroline J.; Brown, Mathew B.; Stephensen, David. 2018. "Postural Stability Is Affected in Older Males with Haemophilia—A Matched Control Study." J. Funct. Morphol. Kinesiol. 3, no. 1: 10.
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