Functional clinical motor performance tests to assess potential fall risks in patients with haemophilia: A case-control study

IF 3 2区医学 Q2 HEMATOLOGY Haemophilia Pub Date : 2024-06-04 DOI:10.1111/hae.15060

Fabian Tomschi, Marius Brühl, Alexander Schmidt, Pia Ransmann, Andreas C. Strauss, Thomas Hilberg

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Abstract

Introduction

Patients with haemophilia (PwH) are at increased risk of falls due to haemophilic arthropathy. Yet, studies on clinical tests associated with the risk of falling are scarce in PwH.

Aims

(1) To evaluate the feasibility of different clinical motor performance tests associated with the risk of falling in PwH; (2) to evaluate PwH's performance of these tests compared to a control group; (3) to identify possible influencing factors that affect performance.

Methods

Twenty-nine severe and moderate PwH (57.0 years, IQR: 48.0–61.5) and 29 healthy age- and BMI-matched control participants (CG) performed 13 different clinical tests (SPPB, timed up and go, push and release, functional reach, single-leg stance, knee and grip strength). Haemophilia joint health score (HJHS), kinesiophobia (TSK-11), subjective physical performance (HEP-Test-Q), falls efficiency (FES-I) and falls were assessed.

Results

No adverse events occurred. PwH showed impaired performance in all clinical tests, a lower falls efficiency and a higher HJHS than CG. PwH with higher HJHS, lower HEP-Test-Q and higher TSK-11 scores showed higher deficits. Largest discrepancies were observed in the single-leg stance with eyes open and knee extensor strength, where orthopaedically majorly affected PwH showed worse performance compared to minorly affected PwH and the CG, respectively. The prevalence of ≥1 fall in the last year was 27.6% (PwH) and 10.3% (CG).

Conclusion

These clinical tests are feasible in PwH. Impaired joint status, a high kinesiophobia and low physical performance impair performance. These tests can be used by clinicians for gaining specific information on functional motor abilities of patients.

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评估血友病患者潜在跌倒风险的功能性临床运动表现测试：病例对照研究

简介血友病患者因血友病关节病而增加了跌倒的风险。目的：（1）评估与血友病患者跌倒风险相关的不同临床运动表现测试的可行性；（2）与对照组相比，评估血友病患者在这些测试中的表现；（3）确定影响表现的可能影响因素：29 名重度和中度血友病患者（57.0 岁，IQR：48.0-61.5）与 29 名年龄和体重指数相匹配的健康对照组参与者（CG）进行了 13 项不同的临床测试（SPPB、定时起立、推放、功能性伸展、单腿站立、膝关节和握力）。对血友病关节健康评分（HJHS）、运动恐惧症（TSK-11）、主观体能表现（HEP-Test-Q）、跌倒效率（FES-I）和跌倒情况进行了评估：结果：无不良事件发生。与 CG 相比，PwH 在所有临床测试中的表现均受损，跌倒效率较低，HJHS 较高。HJHS较高、HEP-Test-Q较低和TSK-11得分较高的患者表现出更严重的缺陷。在睁眼单腿站立和膝关节伸展力量方面观察到的差异最大，与轻度受矫形影响的残疾人和 CG 相比，轻度受矫形影响的残疾人的表现更差。过去一年中跌倒次数≥1次的比例分别为27.6%（PwH）和10.3%（CG）：结论：这些临床测试对 PwH 是可行的。结论：这些临床测试在残疾人中是可行的，但关节受损、运动恐惧和体能低下会影响测试结果。临床医生可通过这些测试获得有关患者运动功能能力的具体信息。

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来源期刊

Haemophilia 医学-血液学

CiteScore

6.50

自引率

28.20%

发文量

226

审稿时长

3-6 weeks

期刊介绍： Haemophilia is an international journal dedicated to the exchange of information regarding the comprehensive care of haemophilia. The Journal contains review articles, original scientific papers and case reports related to haemophilia care, with frequent supplements. Subjects covered include: clotting factor deficiencies, both inherited and acquired: haemophilia A, B, von Willebrand''s disease, deficiencies of factor V, VII, X and XI replacement therapy for clotting factor deficiencies component therapy in the developing world transfusion transmitted disease haemophilia care and paediatrics, orthopaedics, gynaecology and obstetrics nursing laboratory diagnosis carrier detection psycho-social concerns economic issues audit inherited platelet disorders.