Stability, Balance, and Physical Variables in Patients with Bilateral Hemophilic Arthropathy of the Ankle versus Their Healthy Peers: A Case–Control Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design
2.2. Ethical Considerations
2.3. Participants
2.4. Sample Size
2.5. Procedures
2.6. Outcome Measures
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- The primary variable was balance. The secondary variables were ankle dorsiflexion range of motion, functionality, and ankle dorsal strength. All evaluations were performed by a physiotherapist with more than 20 years of clinical experience. The measuring instruments used to measure the study variables were:
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- Stabilometric analysis was performed with an Rs Scan® pressure platform (RSscan Lab Ltd., Ipswich, UK) and a FootScan® pressure measurement system (RSscan Lab Ltd., Ipswich, UK). This biomechanical examination device has shown moderate to good reliability. It measures foot pressure using an X-Y array of resistive pressure-sensitive sensors that are sequentially scanned. The system records the pressure data when the subject is standing or walking on the platform. The measurements were taken with the basic 0.5 m platform with 4096 sensors and resistive technology and 300 Hz data acquisition frequency. Static stability and balance were analyzed with eyes open and closed with a duration of 30 s [22].
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- The Leg Motion® device (Check your MOtion, Albacete, Spain) was used to evaluate ankle dorsal flexion. This tool has shown its high reliability and accessibility in measuring the range of motion of ankle dorsiflexion in adults. The test was performed according to weight-bearing lunge test procedures. The subjects stood on the Leg Motion system, with the first toe on the starting line and the knee in contact with the metal guide of the instrument. While the patients maintained that position, they were told how to lunge forward flexing the knee so as to touch the metal guide, which slides forward until reaching the maximum dorsal flexion of the ankle. During the test, patients were not allowed to take their heel off the ground, and the knee was to maintain contact with the metal guide at all times. Maximum dorsal flexion was defined as the maximum distance from the toe to the metal rod. Three measurements were taken on each ankle, with the average value being used for data analysis. All measurements were performed with the patient barefoot [23].
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- The 2-Minute Walk Test (2MWT) was used to measure lower-limb functionality. The functional capacity to exercise was evaluated using this modified and validated version of the 6-minute format. This test was carried out in a closed corridor that was 30 meters long and delimited by cones. Before the test, the participants rested for at least 10 minutes [24]. They were asked to walk the circuit, going around the cones as fast as possible, but without running, for 2 minutes. Where necessary, they were allowed to slow down or stop to rest [25]. The distance covered, in meters, at the end of the 2 min was recorded by the evaluator [24].
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- The maximum isometric force of the ankle flexor muscles in both legs was evaluated by dynamometry. A manual dynamometer was used, namely, Lafayette Manual Muscle Tester model 01165. This instrument has shown good intra- and inter-rater reliability. The unit of measurement of this instrument is Newtons per square centimeter (N/cm2), where the higher the score, the greater the muscle strength.
2.7. Statistical Analysis
3. Results
4. Discussion
4.1. Relevance to Clinical Practice
4.2. Limitations of the Study
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | Cases (n = 10) | Controls (n = 12) | Sig. |
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Age (years) | 42.60 (16.30) | 38.08 (10.27) | 0.62 |
Weight (kg) | 80.60 (17.35) | 80.50 (8.70) | 0.92 |
Height (m) | 1.72 (0.11) | 1.82 (0.08) | 0.06 |
Body mass index (kg/m2) | 27.07 (4.75) | 24.34 (1.85) | 0.18 |
Ankle joint damage (0–40) | 23.80 (6.09) | - | |
Knee joint damage (0–80) | 18.10 (10.44) | - |
Variables | Cases (n = 10) | Controls (n = 12) | MD (95%CI) | ES | |
---|---|---|---|---|---|
Eyes open | Left (mm) | 51.81 ± 8.63 | 49.22 ± 4.03 | −2.58 (−8.40; 3.24) | −0.38 |
Right (mm) | 48.19 ± 8.64 | 50.49 ± 3.88 | 2.30 (−3.47; 8.08) | 0.35 | |
Anterior (mm) | 50.31 ± 8.35 | 46.24 ± 5.85 | −4.06 (−10.39; 2.25) | −0.56 | |
Posterior (mm) | 49.68 ± 8.36 | 53.75 ± 5.86 | 4.06 (−2.25; 10.39) | 0.57 | |
Min-X (mm) | 0.46 ± 2.15 | 0.61 ± 2.15 | 0.14 (−1.77; 2.06) | 0.07 | |
Min-Y (mm) | −6.66 ± 2.79 | −8.16 ± 3.55 | −1.50 (−4.38; 1.38) | −0.46 | |
Max-X (mm) | 4.53 ± 1.91 | 5.50 ± 1.72 | 0.96 (−0.65; 2.58) | 0.53 | |
Max-Y (mm) | 0.76 ± 2.29 | 1.24 ± 2.77 | 0.48 (−1.81; 2.77) | 0.07 | |
Area (mm2) | 3.80 ± 2.72 | 6.44 ± 3.42 | 2.64 (−0.14; 5.43) | 0.83 | |
Eyes closed | Left (mm) | 49.52 ± 9.99 | 49.96 ± 3.84 | 0.44 (−6.06; 6.95) | 0.06 |
Right (mm) | 47.14 ± 10.41 | 50.03 ± 3.84 | 2.88 (−3.84; 9.62) | 0.37 | |
Anterior (mm) | 48.39 ± 10.58 | 45.62 ± 5.75 | −2.76 (−10.16; 4.63) | −0.32 | |
Posterior (mm) | 48.27 ± 10.83 | 54.37 ± 5.75 | 6.09 (−1.42; 13.62) | 0.72 | |
Min-X (mm) | 1.63 ± 1.75 | 1.02 ± 2.41 | −0.60 (−2.52; 1.31) | −0.34 | |
Min-Y (mm) | −7.90 ± 3.28 | −7.58 ± 2.95 | 0.31 (−2.45; 3.09) | 0.10 | |
Max-X (mm) | 6.63 ± 2.48 | 5.83 ± 1.81 | −0.80 (−2.71; 1.11) | −0.36 | |
Max-Y (mm) | 0.23 ± 1.33 | 3.19 ± 3.66 | 2.96 (0.40; 5.51) * | 0.67 | |
Area (mm2) | 4.89 ± 3.35 | 6.83 ± 2.82 | 1.93 (−0.81; 4.68) | 0.63 | |
Dorsal flexion (degree) | −1.15 ± 6.74 | 14. 05 ± 5.87 | 16.98 (13.99; 19.96) ** | 7.46 | |
Dorsal strength (N) | 172.70 ± 58.77 | 309.50 ± 59.52 | 122.75 (95.55; 149.96) ** | 2.76 | |
Functionality (m) | 160.00 ± 57.5 | 195.00 ± 17.5 | 34.96 (8.49; 61.43) * | 1.18 |
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Truque-Díaz, C.; Meroño-Gallut, J.; Molina-García, C.; Cuesta-Barriuso, R.; Pérez-Llanes, R. Stability, Balance, and Physical Variables in Patients with Bilateral Hemophilic Arthropathy of the Ankle versus Their Healthy Peers: A Case–Control Study. Life 2024, 14, 1051. https://doi.org/10.3390/life14081051
Truque-Díaz C, Meroño-Gallut J, Molina-García C, Cuesta-Barriuso R, Pérez-Llanes R. Stability, Balance, and Physical Variables in Patients with Bilateral Hemophilic Arthropathy of the Ankle versus Their Healthy Peers: A Case–Control Study. Life. 2024; 14(8):1051. https://doi.org/10.3390/life14081051
Chicago/Turabian StyleTruque-Díaz, Carlos, Javier Meroño-Gallut, Cristina Molina-García, Rubén Cuesta-Barriuso, and Raúl Pérez-Llanes. 2024. "Stability, Balance, and Physical Variables in Patients with Bilateral Hemophilic Arthropathy of the Ankle versus Their Healthy Peers: A Case–Control Study" Life 14, no. 8: 1051. https://doi.org/10.3390/life14081051