Joint reaction and simulated muscle forces during squatting and walking in persons with hemophilia.

Arthropathy Bilateral squat Gait analysis Hemophilia Musculoskeletal model

Journal

Clinical biomechanics (Bristol, Avon)
ISSN: 1879-1271
Titre abrégé: Clin Biomech (Bristol, Avon)
Pays: England
ID NLM: 8611877

Informations de publication

Date de publication:
09 Oct 2024
Historique:
received: 19 06 2024
revised: 06 09 2024
accepted: 04 10 2024
medline: 27 10 2024
pubmed: 27 10 2024
entrez: 26 10 2024
Statut: aheadofprint

Résumé

Persons with hemophilia experience joint bleeding that can lead to debilitating arthropathy, most commonly seen in ankles, knees, and elbows. Arthropathy can hinder participation in daily and athletic activities. We explored how hemophilic arthropathy impacts movement patterns in walking and bilateral squatting tasks in persons with hemophilia compared to healthy controls. Persons with hemophilia and healthy controls completed walking and squatting tasks while kinematic and kinetic motion capture data were collected. The Hemophilia Joint Health Score exam was performed to measure hemophiliac arthropathy. OpenSim was used to model muscle and joint reaction forces and calculate moments and angles. Peak values were compared using Cohen's d to estimate effect sizes of hemophilia on movement parameters. Nine persons with hemophilia and eight age-matched controls were analyzed. Temporal-spatial metrics were similar between hemophilia and control groups in both tasks. In walking, persons with hemophilia had higher peak ankle dorsiflexion angles, vertical ground reaction force weight acceptance peaks, and hip extension and flexion moments compared to controls. In squatting, persons with hemophilia had lower knee extension moments, ankle joint reaction force, and knee extensor forces, but had higher hip extension moments. Temporal-spatial metric similarity between hemophilia and controls suggests that kinetic and kinematic analyses are needed to identify movement pattern differences. These data identify potential compensatory strategies at the hip that may be used by persons with hemophilia to mitigate impact on the knee and ankle. Future work will confirm these data in a larger sample size and be used to develop physical therapy strategies.

Sections du résumé

BACKGROUND BACKGROUND
Persons with hemophilia experience joint bleeding that can lead to debilitating arthropathy, most commonly seen in ankles, knees, and elbows. Arthropathy can hinder participation in daily and athletic activities. We explored how hemophilic arthropathy impacts movement patterns in walking and bilateral squatting tasks in persons with hemophilia compared to healthy controls.
METHODS METHODS
Persons with hemophilia and healthy controls completed walking and squatting tasks while kinematic and kinetic motion capture data were collected. The Hemophilia Joint Health Score exam was performed to measure hemophiliac arthropathy. OpenSim was used to model muscle and joint reaction forces and calculate moments and angles. Peak values were compared using Cohen's d to estimate effect sizes of hemophilia on movement parameters.
FINDINGS RESULTS
Nine persons with hemophilia and eight age-matched controls were analyzed. Temporal-spatial metrics were similar between hemophilia and control groups in both tasks. In walking, persons with hemophilia had higher peak ankle dorsiflexion angles, vertical ground reaction force weight acceptance peaks, and hip extension and flexion moments compared to controls. In squatting, persons with hemophilia had lower knee extension moments, ankle joint reaction force, and knee extensor forces, but had higher hip extension moments.
INTERPRETATION CONCLUSIONS
Temporal-spatial metric similarity between hemophilia and controls suggests that kinetic and kinematic analyses are needed to identify movement pattern differences. These data identify potential compensatory strategies at the hip that may be used by persons with hemophilia to mitigate impact on the knee and ankle. Future work will confirm these data in a larger sample size and be used to develop physical therapy strategies.

Identifiants

DOI: 10.1016/j.clinbiomech.2024.106361 PMID: 39461281
pubmed: 39461281
pii: S0268-0033(24)00193-1
doi: 10.1016/j.clinbiomech.2024.106361
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

106361

Informations de copyright

Copyright © 2024. Published by Elsevier Ltd.

Déclaration de conflit d'intérêts

Declaration of competing interest Beth Boulden Warren reports financial support was provided by National Institutes of Health. Beth Boulden Warren reports financial support was provided by Maternal and Child Health Bureau. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Joseph Mah (J)

Hemophilia and Thrombosis Center, University of Colorado Anschutz Medical Campus, 13199 E Montview Blvd, Aurora, CO 80045, United States of America.

Caden Robertson (C)

Hemophilia and Thrombosis Center, University of Colorado Anschutz Medical Campus, 13199 E Montview Blvd, Aurora, CO 80045, United States of America.

Niamh Mah (N)

Hemophilia and Thrombosis Center, University of Colorado Anschutz Medical Campus, 13199 E Montview Blvd, Aurora, CO 80045, United States of America.

Joanna Roybal (J)

Hemophilia and Thrombosis Center, University of Colorado Anschutz Medical Campus, 13199 E Montview Blvd, Aurora, CO 80045, United States of America.

Dianne Thornhill (D)

Hemophilia and Thrombosis Center, University of Colorado Anschutz Medical Campus, 13199 E Montview Blvd, Aurora, CO 80045, United States of America.

Sharon Funk (S)

Hemophilia and Thrombosis Center, University of Colorado Anschutz Medical Campus, 13199 E Montview Blvd, Aurora, CO 80045, United States of America.

Marilyn J Manco-Johnson (MJ)

Hemophilia and Thrombosis Center, University of Colorado Anschutz Medical Campus, 13199 E Montview Blvd, Aurora, CO 80045, United States of America.

James Carollo (J)

Center for Gait and Movement Analysis, Children's Hospital Colorado, 13123 E 16th Ave, Aurora, CO 80045, United States of America.

Brecca M M Gaffney (BMM)

Department of Mechanical Engineering, University of Colorado Denver, 1200 Larimer Street, Denver, CO 80204, United States of America; Center for Bioengineering, University of Colorado Anschutz Medical Campus,12705 E Montview Blvd, Aurora, CO 80045, United States of America.

Beth Boulden Warren (BB)

Hemophilia and Thrombosis Center, University of Colorado Anschutz Medical Campus, 13199 E Montview Blvd, Aurora, CO 80045, United States of America. Electronic address: beth.warren@cuanschutz.edu.

Classifications MeSH