Electromyographic and Safety Comparisons of Common Lower Limb Rehabilitation Exercises for People With Hemophilia
Author
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Calatayud, Joaquín
Author
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Pérez Alenda, Sofía
Author
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Carrasco, Juan J.
Author
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Escriche Escuder, Adrián
Author
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Cruz Montecinos, Carlos
Author
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Andersen, Lars L.
Author
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Bonanad, Santiago
Author
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Querol, Felipe
Author
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Casaña, José
Admission date
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2020-07-03T02:47:43Z
Available date
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2020-07-03T02:47:43Z
Publication date
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2020
Cita de ítem
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Physical Therapy Volume Volumen 100 Number 1 2020
es_ES
Identifier
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10.1093/ptj/pzz146
Identifier
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https://repositorio.uchile.cl/handle/2250/175785
Abstract
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Background. Ankles and knees are commonly affected in people with hemophilia and
thus are targets for prevention or rehabilitation. However, to our knowledge, no studies
have evaluated muscle activity and safety during exercises targeting the lower limbs in
people with hemophilia; this lack of information hinders clinical decision-making.
Objective. The aim of this study was to compare the tolerability of, safety of, and
muscle activity levels obtained with external resistance (elastic or machine)-based and
non–external resistance-based lower limb exercises in people with hemophilia.
Design. This was a cross-sectional study.
Methods. Eleven people who had severe hemophilia and were undergoing prophylactic
treatment participated. In a single experimental session, participants performed knee
extension and ankle plantar flexion during 3 exercise conditions in random order: elastic
band-based resistance (elastic resistance), machine-based resistance (machine resistance),
and no external resistance. Exercise intensities for the 2 external resistance-based conditions
were matched for perceived exertion. Muscle activity was determined using surface
electromyography (EMG) for the rectus femoris, biceps femoris, gastrocnemius lateralis,
and tibialis anterior muscles. Participants were asked to rate exercise tolerability according
to a scale ranging from “very well tolerated” to “not tolerated” and to report possible
adverse effects 24 and 48 hours after the session.
Results. No adverse effects were reported, and exercise tolerability was generally high. In
the knee extension exercise, the rectus femoris normalized EMG values during the elastic
resistance and machine resistance conditions were similar; 29% to 30% higher activity was
obtained during these conditions than during the non–external resistance condition. In the
ankle plantar flexion exercise, the gastrocnemius lateralis normalized EMG value was 34%
higher during the machine resistance condition than without external resistance, and the
normalized EMG values during the elastic resistance and other conditions were similar.
Limitations. The small sample size and single training session were the primary
limitations of this study.
Conclusions. Exercises performed both with elastic bands and with machines at
moderate intensity are safe, feasible, and efficient in people with severe hemophilia,
providing comparable activity levels in the agonist muscles.