Abstract
A small number of studies have reported that children and adults with haemophilia have impaired balance control and show faster body sway during upright stance than healthy individuals. A decrease of somatosensory information due to multiple bleedings has been suggested to explain this difference. Therefore, the objective of this study was to examine if haemophilia is related to a decreased balance control under altered visual and proprioceptive conditions in male adolescents. Postural sway of healthy (n = 12, Age = 14.8 ± 1.4 years; BMI = 19.8 ± 1.8 kg/m2) and haemophiliac (n = 8, Age = 15.0 ± 1.4 years; BMI = 20.4 ± 3.2 kg/m2) male adolescents was measured with a force platform for normal quiet stance lasting 30 s with open and closed eyes on hard and foam floor conditions. The ANOVA revealed a significant Group × Vision × Proprioception (F(1,18) = 5.861, p < 0.05) interaction. Both groups showed an increased centre of pressure (COP) speed when vision and proprioception are challenged. Planned comparisons revealed that the haemophiliac group oscillated at a faster COP speed than the healthy group when vision is altered in hard floor (1.11 ± 0.27 versus 0.76 ± 0.19 cm/s; p < 0.05) and foam floor (6.83 ± 1.68 versus 4.89 ± 1.05 cm/s; p < 0.01) conditions. More important, haemophiliac adolescents were more disturbed by the proprioceptive condition and had a significantly higher COP speed on the foam even if vision is available (3.02 ± 0.47 versus 2.34 ± 0.45 cm/s; p < 0.05) compared to the healthy adolescents. In conclusion, haemophilia clearly affects postural control in altered sensory conditions. Our results suggest that haemophilia has a negative impact on the capacity of male adolescents to adequately use proprioceptive information for posture control.
Highlights
Human standing is a fundamental part of the activities of daily living and is essentially characterized by sway of the whole body about the ankle joints [1]
The main objective of this study was to determine if haemophilia is associated with a decreased postural stability in male adolescents
The decomposition of the interaction showed that haemophiliac adolescents had significantly higher average speed of centre of pressure (COP) displacement for all visual and proprioceptive conditions compared to healthy adolescents, except for the vision/hard floor condition
Summary
Human standing is a fundamental part of the activities of daily living and is essentially characterized by sway of the whole body about the ankle joints [1]. It has been reported that passive stiffness and open loop mechanisms contribute to the generation of the muscle activity required for stance control [3], which depends on a coordinated effort of the sensory systems (visual, vestibular, and proprioceptive systems). Sensory integration from vision, proprioception, and vestibular organ plays an essential role in quasi-static and dynamic postural control, contributing to the organization and selection of an appropriate motor response when balance is challenged [4]. Deficits in these systems result in impaired balance control and have been clearly identified as a risk factor for falls [5,6,7]. Haemophilia is a medical condition caused by a hereditary lack of a coagulation factor (Haemophilia A/factor VIII and Haemophilia B/factor IX), and haemophiliac individuals present a severely reduced ability of the blood to clot, which results in a longer bleeding time after an injury [8]
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