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Effects of top rope climbing therapy on joint health in adult haemophilia patients with severe arthropathies

The Journal of Haemophilia Practice
Volume 5 (2018): Issue 1 (April 2018)
By:
Open Access
|Dec 2018

Figures & Tables

Image: Properly managed physical activity has been shown to have haematologic, musculoskeletal and psychosocial benefits in people with haemophilia. Top rope climbing is an increasingly popular sport and tailored courses may be beneficial to those with arthropathic joints© Shutterstock
Image: Properly managed physical activity has been shown to have haematologic, musculoskeletal and psychosocial benefits in people with haemophilia. Top rope climbing is an increasingly popular sport and tailored courses may be beneficial to those with arthropathic joints© Shutterstock

Figure 1

The Yosemite Decimal System (YDS) measured changes in climbing skills during the study. All subjects started at level 6, between step 5 and 6 of the YDS
The Yosemite Decimal System (YDS) measured changes in climbing skills during the study. All subjects started at level 6, between step 5 and 6 of the YDS

Figure 2A

Power doppler signal pre- and post-climbing program. Power doppler (PD) signal was assessed with MSKUS before and after completion of the climbing program. Three representative views in each joint were combined for PD scoring (0 indicates absent signal; 9 represents highest signal intensity). The line graph represents the PD signal score before and after climbing for each joint
Power doppler signal pre- and post-climbing program. Power doppler (PD) signal was assessed with MSKUS before and after completion of the climbing program. Three representative views in each joint were combined for PD scoring (0 indicates absent signal; 9 represents highest signal intensity). The line graph represents the PD signal score before and after climbing for each joint

Figure 2B

Representative example of soft tissue inflammation before and after the climbing program assessed by power doppler, detecting abnormal vascularity as marker of inflammation. A substantial reduction of inflammation post-climbing is depicted in longitudinal axis of the elbow humero-radial joint
Representative example of soft tissue inflammation before and after the climbing program assessed by power doppler, detecting abnormal vascularity as marker of inflammation. A substantial reduction of inflammation post-climbing is depicted in longitudinal axis of the elbow humero-radial joint

Figure 1

Joint Activity and Damage Exam (JADE) protocol cartilage and soft tissue measurements. The JADE protocol is a musculoskeletal ultrasound (MSKUS) algorithm to assess soft tissue expansion, osteochondral abnormalities, and vascular abnormalities in sentinel areas of joints. Representative MSKUS images of the JADE protocol measurements of cartilage thickness and soft tissue expansion in the elbow, knee, and ankle joint are compared showing normal and abnormal structures
Joint Activity and Damage Exam (JADE) protocol cartilage and soft tissue measurements. The JADE protocol is a musculoskeletal ultrasound (MSKUS) algorithm to assess soft tissue expansion, osteochondral abnormalities, and vascular abnormalities in sentinel areas of joints. Representative MSKUS images of the JADE protocol measurements of cartilage thickness and soft tissue expansion in the elbow, knee, and ankle joint are compared showing normal and abnormal structures

Baseline patient and joint characteristics

VARIABLESUCSD SUBJECTS
Number of patients6
Age [range]31
Haemophilia A6
Haemophilia B0
Prophylactic clotting factor therapy6
On-demand clotting factor therapy0
Median HJHS [range]17.5
Number of patients with:
One arthropathic joint2
Two arthropathic joints2
Three or more arthropathic joints2
Joints with arthropathies:
Arthropathic elbows7
Arthropathic knees3
Arthropathic ankles5
Total arthropathic joints15

Comparison of musculoskeletal ultrasound (MSKUS) measurements of cartilage, soft tissue proliferation*

ELBOW
PrePostPostPrePostPrePostPrePostPrePostPre
RC01 leftRC01 rightRC03 rightRC04 leftRC05 leftRC06 right
Ant elbow LAX cartilage thickness (cm)0.070.08000000.080000
Ant elbow LAX - PD (1-3)122022202021
Ant elbow SAX - PD (1-3)111101110020
Post elbow - fossa expansion LAX (cm)3.283.233.763.554.684.813.333.664.864.984.743.66
Post elbow - fossa expansion SAX (cm)1.041.071.061.031.611.551.11.071.571.512.071.55
Post elbow - fossa expansion circumference (cm)7.787.418.988.3211.1411.337.548.5211.7812.0512.139.35
Post elbow - fossa area (cm)1.791.611.851.743.593.341.821.875.184.765.623.28
Post elbow - PD (1-3)212221302222
KNEE
PrePostPrePost
RC04 rightRC06 right
Sunrise - cartilage thickness (cm)TKATKA
Lateral recess (cm)0.530.41.81.054
Lateral recess - PD (1-3)3220
Medial recess (cm)0.610.590.670.53
Medial recess- PD (1-3)2103
Medial meniscus and MCL - PD (1-3)02
Suprapatellar bursa - PD (1-3)2121
ANKLE
PrePostPrePostPrePostPrePostPrePost
RC01 rightRC02 leftRC04 rightRC06 leftRC06 right
Ant ankle LAX - cartilage thickness (cm)0000000000
Ant ankle LAX- PD (1-3)2022210000
Ant ankle SAX - capsular interface thickness (cm)0.810.540.670.650.980.950.281.041.030.47
Ant ankle SAX- PD (1-3)2220202113
Achilles tendon (cm)0.390.390.40.38
Sinus tarsi - PD (1-3)1222
DOI: https://doi.org/10.17225/jhp00115 | Journal eISSN: 2055-3390
Journal RSS Feed
Language: English
Page range: 93 - 102
Published on: Dec 14, 2018
Published by: Haemnet Ltd
In partnership with: Paradigm Publishing Services
Publication frequency: 1 times per year
Keywords:
Arthropathy,
Climbing,
Haemophilia,
Physical activity,
Ultrasound
Related subjects:
Medicine,
Basic medical science,
Basic medical science, other,
Clinical medicine,
Clinical medicine, other,
Pharmacy,
Pharmacology

© 2018 Courtney Schroeder, Richard FW Barnes, Lena Volland, Sonha Nguyen, Annette von Drygalski, published by Haemnet Ltd
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

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