Peak pressure during gait in patients with severe haemophilia: A controlled cross-sectional study |
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| Affiliation: | 1. University of Wuppertal, Department of Sports Medicine, Moritzstraße 14, 42117 Wuppertal, Germany;2. University of Bonn, Department of Orthopaedics and Trauma Surgery, Venusberg Campus 1, 53127 Bonn, Germany;3. University of Bonn, Institute for Experimental Haematology and Transfusion Medicine, Venusberg Campus 1, 53127 Bonn, Germany;1. Department of Health Professions, Physical Therapy Program, University of Wisconsin, 1300 Badger Street, La Crosse, WI, United States;2. La Crosse Institute for Movement Science (LIMS), University of Wisconsin, 1300 Badger Street, La Crosse, WI, United States;3. Gundersen Health System, Sports Medicine Department, 311 Gundersen Drive, Onalaska, WI, United States;1. Prosthetic & Orthotics and Assistive Technology, Graduate School, Niigata University of Health and Welfare, Niigata, Japan;2. Department of Human Environment Design, Faculty of Human Life Design, Toyo University, Tokyo, Japan;3. Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, The University of Tokyo Hospital, Tokyo, Japan;4. Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, Tokyo, Japan;1. Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, ACT, Australia;2. Brain Stimulation and Rehabilitation (BrainStAR) Lab, Western Sydney University, NSW, Australia;3. IIMPACT in Health, Allied Health and Human Performance, University of South Australia, SA, Australia;4. Research Institute for Sport and Exercise, University of Canberra, ACT, Australia;1. Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Tel Hashomer, Israel;2. Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be’er Sheva, Israel;3. Department of Neurological Rehabilitation, Sheba Medical Center, Tel HaShomer, Israel;4. Department of Physical and Rehabilitation Medicine, Faculty of Medicine, Tel Aviv University, Israel;5. School of Health Professions, Ono Academic College, Kiryat Ono, Israel;6. Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel;7. Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel;1. Biomechanics Laboratory, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil;2. Physical Education Department, University Center of Brusque, Brusque, Santa Catarina, Brazil;3. Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada;4. Morphological Sciences Department, School of Biological Sciences, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil |
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| Abstract: | ![]()
BackgroundPatients with severe haemophilia suffer from bleeding-related joint changes in which the ankle joint is most frequently affected. In the resulting gait changes, the forefoot is involved by reducing the foot pressure. However, it is unclear which changes in foot pressure are present in the individual's foot zones.Research questionThe aim of the study was to determine whether compensation mechanisms are present in the foot zones regarding the peak pressure under dynamic conditions and to identify possible underlying mechanisms for gait changes.MethodsIn a controlled cross-sectional study, a pedobarography was performed during gait with a standardized speed (3 km/h) in patients with haemophilia (PwH;n = 40) and healthy controls (Con;n = 40). Pressure pain thresholds (PPT) were detected, and Haemophilia Joint Health Score (HJHS) was performed to determine the current joint status.ResultsPwH showed a decreased peak pressure in metatarsals II-IV and heel compared to Con. Patients with major-affected ankle joints (determined with the HJHS) showed a decreased single-step length, stride-length and stride-time. Accordingly, the cadence was increased by 10 ± 11 steps/min in PwH compared to Con. Furthermore, PwH showed decreased ankle range of motion (ROM) in HJHS and an altered pain perception due to reduced PPT.SignificancePwH showed a changed gait pattern in peak pressure compared to Con. A restricted rolling behavior, which might be caused by movement restrictions and pain sensation, leads to reduced pressure in the center forefoot, resulting in a shorter stride-length.Future therapies should focus on maintaining joint mobility for better rolling behavior and improving ankle joints' stability to achieve a balanced load between the midfoot, heel, and forefoot. The use of insoles adapted to our data, based on group differences between PwH and Con, could be supportive in this case. |
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| Keywords: | Arthropathy Joint changes Pedobarography Maximum pressure Ankle |
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