One Session Effects of Knee Motion Visualization Using Immersive Virtual Reality in Patients with Hemophilic Arthropathy.

Roberto Ucero-Lozano,José Antonio López-Pina,Rubén Cuesta-Barriuso,Raúl Pérez-Llanes

doi:10.3390/jcm10204725

Abstract

(1) Background: Hemophilic knee arthropathy is characterized by a loss of muscle mass and decreased strength of the quadriceps muscle. The visualization of movement aims to favor the recruitment of the motor system in the same premotor and parietal areas, as would happen with the active execution of the observed action. The aim was to evaluate changes in quadriceps activation in patients with hemophilic knee arthropathy following immersive VR visualization of knee extension movements. (2) Methods: We recruited 13 patients with severe hemophilia A and knee arthropathy. Patients underwent a 15 min session of immersive VR visualization of knee extension movements. The quadriceps muscle activation was evaluated by surface electromyography. (3) Results: After the intervention, there were no changes in the muscle activation of vastus medialis, vastus lateralis, or rectus femoris muscles. There was a large effect size of changes in rectus femoris muscle activation. Age and knee joint damage did not correlate with changes in quadriceps activation. Dominance, inhibitor development, and type of treatment were not related with post-intervention muscle activation. (4) Conclusions: A session of immersive VR visualization of knee extension movement does not modify quadriceps muscle activation. A specific protocol for patients with hemophilic knee arthropathy may be effective in improving the activation of the rectus femoris muscle.

Highlights

Hemophilia is a congenital coagulopathy characterized by a deficiency of a clotting factor
A specific protocol for patients with hemophilic knee arthropathy may be effective in improving the activation of the rectus femoris muscle
All patients had a medical diagnosis of hemophilia A with a severe phenotype (

Summary

Introduction

Hemophilia is a congenital coagulopathy characterized by a deficiency of a clotting factor. Most bleeding events are intra-articular (hemarthrosis) and mainly in the lower limbs, due to pressure and loads on the knees and ankles [2,3]. These bleeding events, recurring from early childhood, lead to degenerative and chronic joint deterioration (hemophilic arthropathy) [4]. The regular administration of clotting factor concentrates (prophylactic treatment) is the most effective way of controlling hemarthrosis and hemophilic arthropathy [5]. The development of antibodies against the treatment with clotting factor concentrates (inhibitors) is the main clinical complication in these patients and increases the rate of musculoskeletal sequelae

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