Abstract Topic: 33. Bleeding disorders (congenital and acquired)
Background: Despite developing treatment options, adult patients with hemophilia still
face musculoskeletal problems such as balance problems, muscle weakness and prorioceptive
loss. These problems also lead to decreased physical activity and inactivity over
time.
Aims: The purpose of this study was to examine the association between balance confidence,
kinesiophobia and leg muscle strength in adult patients with hemophilia.
Methods: Patients with hemophilia A or B aged between 18-60 years were recruited from
the Ege Adult Haemophilia and Thrombosis Center to participate in the study. The lower
extremity muscle strength of the participants was evaluated with a handheld dynamometer.
Tampa Scale of Kinesiophobia(TSK) was used to evaluate kinesiophobia and Activity-specific
Balance Confidence Scale(ABC) was used for balance confidence evaluation. Correlations
were calculated between all testing variables using Spearman correlation coefficients,
and p < 0.05 was considered statistically significant.
Results: A total of seventeen patiens; 10 with hemophilia A and 7 with hemophilia
B (mean age = 37.59 ± 14.3 years, mean BMI = 24.56 ± 3.87 kg/m2) participated in this
study. Seven had moderate and 10 had severe hemophilia No significant correlations
were found between kinesiophobia and any of the strength measures (p>0.05). However,
significant correlations were found between balance confidence and both hamstring
and ankle dorsiflexors’ strength (p<0.05*).
Summary/Conclusion: In patients with high hamstring and ankle dorsiflexors’ muscle
strength, it will be easier to use the ankle strategy to control the forward and backward
postural oscillations at low speeds and help to maintain balance. Therefore, it is
normal for these people to have high balance confidence. However, this result is limited
by the small number of subjects in this study and requires further investigation.
Table 1. Correlations between each measured variable of kinesiophobia, balance confidence
and leg muscle strength
TSK
ABC
Quad. Strength- R(Newton)
Quad. Strength- L(Newton)
Hams. Strength-R (Newton)
Hams. Strength-L (Newton)
DF Strength-R (Newton)
DF Strength-L (Newton)
PF Strength- R (Newton)
PF Strength- L (Newton)
TSK
.
0,426
0,383
0,896
0,200
0,253
0,438
0,506
1,000
0,503
ABC
0,426
.
0,193
0,230
0,013*
0,003*
0,013*
0,019*
0,337
0,285
Quad. Strength- R (Newton)
0,383
0,193
.
0,003*
0,002*
0,001*
0,043*
0,016*
0,119
0,000*
Quad. Strength- L (Newton)
0,896
0,230
0,003*
.
0,016*
0,003*
0,013*
0,036*
0,058
0,055
Hams. Strength- R (Newton)
0,200
0,013*
0,002*
0,016*
.
0,000*
0,008*
0,008*
0,001*
0,000*
Hams. Strength- L (Newton)
0,253
0,003*
0,001*
0,003*
0,000*
.
0,000*
0,000*
0,002*
0,000*
DF Strength-R (Newton)
0,438
0,013*
0,043*
0,013*
0,008*
0,000*
.
0,000*
0,004*
0,003*
DF Strength-L (Newton)
0,506
0,019*
0,016*
0,036*
0,008*
0,000*
0,000*
.
0,010*
0,002*
PF Strength-R (Newton)
1,000
0,337
0,119
0,058
0,001*
0,002*
0,004*
0,010*
.
0,001*
PF Strength-L (Newton)
0,503
0,285
0,000*
0,055
0,000*
0,000*
0,003*
0,002*
0,001*
.
Spearman correlation; Significant correlation: p<0.05
TSK: Tampa Scale of Kinesiophobia; ABC: Activity-specific Balance Confidence Scale;
DF: Dorsiflexors; PF: Plantarflexors; Quad: Quadriceps; Hams: Hamstring; R: Right;
L: Left
Keywords: Hemophilia B, Hemophilia A, Hemophilia, Muscle