title: Postural adjustment after an unexpected perturbation in children with haemophilia.
abstract: Children with haemophilia often bleed inside joints and muscles, which may impair postural adjustments. These postural adjustments are necessary to control postural balance during daily activities. The inability to quickly recover postural balance could elevate the risk of bleeding. To determine whether children with haemophilia have impaired postural adjustment after an unexpected perturbation compared with healthy children. Twenty children with haemophilia comprised the haemophilic group (HG), and 20 healthy, age-paired children comprised the control group (CG). Subjects stood on a force plate, and 4% of the subjects' body weight was applied via a pulley system to a belt around the subjects' trunks. The centre of pressure (COP) displacement was measured after the weight was unexpectedly released to produce a controlled postural perturbation followed by postural adjustment to recover balance. The subjects' postural adjustments in eight subsequent intervals of 1 s (t1-t8), beginning with the moment of weight removal, were compared among intervals and between groups. The applied perturbation magnitudes were the same for both groups, and no difference was observed between the groups in t1. However, the COP displacement in t2 in the HG was significantly higher than in the CG. No differences were observed between the groups in the other intervals. Within-group analysis showed that the COP was higher in t2 than in t4 (P = 0.016), t5 (P = 0.001) and t8 (P = 0.050) in the HG. No differences were observed among intervals in the CG. Children with haemophilia demonstrated differences in postural adjustment while undergoing unexpected balance perturbations when compared with healthily children.
authors.affiliation: Department of Physical Therapy, Communication Disorders and Occupational Therapy. University of São Paulo, São Paulo, Brazil.
authors.forename: F M B
authors.initials: FM
authors.lastname: De Souza
authors.forename: R P
authors.initials: RP
authors.lastname: Pereira
authors.forename: N P
authors.initials: NP
authors.lastname: Minuque
authors.forename: C M
authors.initials: CM
authors.lastname: Do Carmo
authors.forename: M H M
authors.initials: MH
authors.lastname: De Mello
authors.forename: P
authors.initials: P
authors.lastname: Villaça
authors.forename: C
authors.initials: C
authors.lastname: Tanaka
mesh_terms: D000704:Analysis of Variance; D016022:Case-Control Studies; D002648:Child; D003430:Cross-Sectional Studies; D006395:Hemarthrosis / Q000503:physiopathology; D006467:Hemophilia A / Q000503:physiopathology*; D002836:Hemophilia B / Q000503:physiopathology*; D006801:Humans; D004856:Postural Balance / Q000502:physiology*