Electromyographic and Safety Comparisons of Common Lower Limb Rehabilitation Exercises for People With Hemophilia

Joaquín Calatayud, Sofía Pérez-Alenda, Juan J Carrasco, Adrián Escriche-Escuder, Carlos Cruz-Montecinos, Lars L Andersen, Santiago Bonanad, Felipe Querol, José Casaña

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

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.

Original languageEnglish
JournalPhysical Therapy
Volume100
Issue number1
Pages (from-to)116-126
Number of pages11
ISSN0031-9023
DOIs
Publication statusPublished - 23 Jan 2020

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Exercise Therapy
Hemophilia A
Electromyography
Lower Extremity
Safety
Muscles
Ankle
Knee
Quadriceps Muscle
Sample Size
Rehabilitation
Cross-Sectional Studies

Bibliographical note

© 2019 American Physical Therapy Association.

Cite this

Calatayud, J., Pérez-Alenda, S., Carrasco, J. J., Escriche-Escuder, A., Cruz-Montecinos, C., Andersen, L. L., ... Casaña, J. (2020). Electromyographic and Safety Comparisons of Common Lower Limb Rehabilitation Exercises for People With Hemophilia. Physical Therapy, 100(1), 116-126. https://doi.org/10.1093/ptj/pzz146
Calatayud, Joaquín ; Pérez-Alenda, Sofía ; Carrasco, Juan J ; Escriche-Escuder, Adrián ; Cruz-Montecinos, Carlos ; Andersen, Lars L ; Bonanad, Santiago ; Querol, Felipe ; Casaña, José. / Electromyographic and Safety Comparisons of Common Lower Limb Rehabilitation Exercises for People With Hemophilia. In: Physical Therapy. 2020 ; Vol. 100, No. 1. pp. 116-126.
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abstract = "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.",
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Calatayud, J, Pérez-Alenda, S, Carrasco, JJ, Escriche-Escuder, A, Cruz-Montecinos, C, Andersen, LL, Bonanad, S, Querol, F & Casaña, J 2020, 'Electromyographic and Safety Comparisons of Common Lower Limb Rehabilitation Exercises for People With Hemophilia', Physical Therapy, vol. 100, no. 1, pp. 116-126. https://doi.org/10.1093/ptj/pzz146

Electromyographic and Safety Comparisons of Common Lower Limb Rehabilitation Exercises for People With Hemophilia. / Calatayud, Joaquín; Pérez-Alenda, Sofía; Carrasco, Juan J; Escriche-Escuder, Adrián; Cruz-Montecinos, Carlos; Andersen, Lars L; Bonanad, Santiago; Querol, Felipe; Casaña, José.

In: Physical Therapy, Vol. 100, No. 1, 23.01.2020, p. 116-126.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Electromyographic and Safety Comparisons of Common Lower Limb Rehabilitation Exercises for People With Hemophilia

AU - Calatayud, Joaquín

AU - Pérez-Alenda, Sofía

AU - Carrasco, Juan J

AU - Escriche-Escuder, Adrián

AU - Cruz-Montecinos, Carlos

AU - Andersen, Lars L

AU - Bonanad, Santiago

AU - Querol, Felipe

AU - Casaña, José

N1 - © 2019 American Physical Therapy Association.

PY - 2020/1/23

Y1 - 2020/1/23

N2 - 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.

AB - 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.

U2 - 10.1093/ptj/pzz146

DO - 10.1093/ptj/pzz146

M3 - Journal article

C2 - 31584672

VL - 100

SP - 116

EP - 126

JO - Physical Therapy

JF - Physical Therapy

SN - 0031-9023

IS - 1

ER -

Calatayud J, Pérez-Alenda S, Carrasco JJ, Escriche-Escuder A, Cruz-Montecinos C, Andersen LL et al. Electromyographic and Safety Comparisons of Common Lower Limb Rehabilitation Exercises for People With Hemophilia. Physical Therapy. 2020 Jan 23;100(1):116-126. https://doi.org/10.1093/ptj/pzz146