Posture and balance control in adults with sickle cell anemia

Abstract

Introduction: Sickle cell anemia (SCA) is a hemolytic, hereditary, and homozygous disease found frequently throughout the world, including Brazil. It is caused by a mutation of hemoglobin, which results in alteration of its conformation leading to several hemoglobinopathies, including SCA. This disease is limiting, mainly due to the events of vaso-occlusion that result in frequent episodes of pain crises and tissue ischemia causing several clinical symptoms and symptoms. Interest in evaluations of cerebrovascular disease and osteomioarticular involvement in SCA is increasing; however, to date there are no studies that have evaluated balance control and posture in this population. Objective: The objective of the present study was to evaluate balance control in adults with SCA and, secondly, to investigate balance associations with posture, muscle function and quality of life in these individuals. Methods: This was a cross-sectional study in which 15 subjects with SCA on outpatient treatment and 18 healthy control subjects were matched for age, gender, weight, height, and body mass index. Postural balance assessments were performed through stabilometry and posture using postural assessment software (SAPO). In addition, measurements of muscle strength were made through handgrip and maximal respiratory pressures, as well as the quality of life assessment using the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) questionnaire. In relation to the controls, the adults with SCA presented greater displacement of the center of pressure in both trials, being this displacement more pronounced in the mediolateral direction, when the visual feedback was removed and in those with a history of vascular accident or transient ischemic attack. Regarding the controls, the adults with SCA showed greater postural deviations for the following variables: right and left hip; right and left leg-heel; and horizontal alignment of the pelvis. Results: There was a positive and significant correlation between the handgrip strength, the mediolateral standard derivation and the mediolateral range. Significant correlations between balance and posture were only observed between the variables of the balance and the postural parameters that involved the angulations calculated from the vertical alignment of the pelvis, hip and ankle. Conclusion: In adults with AF, there is damage to the static balance, especially in the mediolateral direction and in the presence of documented previous cerebrovascular disease. These patients present postural deviations due to changes in the hip and ankle joints. In addition, postural control is related to posture and muscle function. With the results of this research, it is possible to direct the development of new strategies for the treatment of patients with SCA.