Isokinetic knee strength deficit in patients with moderate haemophilia.

Abstract

Listen

Translate article

Knee joint bleedings are responsible for quadriceps atrophy and strength deficit in patients with severe haemophilia. Little is known about patients with moderate haemophilia (PWMH). To evaluate isokinetic quadriceps and hamstrings strength in PWMH and to assess correlation with radiological and clinical parameter. 18 PWMH aged 37.1±11.4 and 18 healthy age-, weight- and height-matched controls performed a knee isokinetic test at 180°/s to assess quadriceps and hamstrings strength. In the PWMH group, knee Pettersson's score was pursued and Haemophilia Joint Health Score 2.1 (HJHS) was performed to determine unaffected knees (knee HJHS=0) and affected ones (knee HJHS >0). Affected knees had a decrease of quadriceps strength compared to controls, 1.26±0.47 vs 1.64±0.27Nm/kg and a decrease of hamstring strength, 0.60±0.29 vs 1.03±0.21Nm/kg, (P<0.001). Unaffected knees also had a decrease of quadriceps strength compared to controls, 1.36±0.31 vs 1.64±0.27Nm/kg and a decrease of hamstring strength, 0.69±0.18 vs 1.03±0.21Nm/kg, (P<0.001). The conventional hamstring-to-quadriceps ratio was significantly decreased in affected knees compared to controls, 0.46±0.15 vs 0.64±0.13 (P<0.001) but also in unaffected knees, 0.53±0.16 vs 0.64±0.13 (P=0.02).No correlation was found between strength and HJHS or Pettersson's score. PWMH have a significant knee strength deficit, both on the quadriceps and the hamstrings, which is responsible for an important muscle imbalance.