{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T23:13:20Z","timestamp":1790205200282,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2012,10,11]],"date-time":"2012-10-11T00:00:00Z","timestamp":1349913600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Haemophilia"],"published-print":{"date-parts":[[2013,3]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Quadriceps weakness seems to be a hallmark in adult persons with severe haemophilia (<jats:styled-content style=\"fixed-case\">PWH<\/jats:styled-content>). The purpose of this study was to compare <jats:styled-content style=\"fixed-case\">PWH<\/jats:styled-content> and non\u2010haemophilic controls in different age stages with reference to joint status and quadriceps strength. Further aims were to examine the extent of strength\u2010specific inter\u2010extremity\u2010difference (<jats:styled-content style=\"fixed-case\">IED<\/jats:styled-content>) and the prevalence of abnormal <jats:styled-content style=\"fixed-case\">IED<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">AIED<\/jats:styled-content>). A total of 106 adults with severe haemophilia (H) and 80 controls (C) had undergone an orthopaedic examination for classification of knee and ankle status using the <jats:styled-content style=\"fixed-case\">WFH<\/jats:styled-content> score. Quadriceps strength was evaluated unilaterally as well as bilaterally with a knee extensor device. Each group was divided into four age\u2010related subgroups (<jats:styled-content style=\"fixed-case\">HA<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">CA<\/jats:styled-content>: 18\u201329, <jats:styled-content style=\"fixed-case\">HB<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">CB<\/jats:styled-content>: 30\u201339, <jats:styled-content style=\"fixed-case\">HC<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content>: 40\u201349, <jats:styled-content style=\"fixed-case\">HD<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>: 50\u201370; in years). H presented a worse knee and ankle status than C indicated by higher <jats:styled-content style=\"fixed-case\">WFH<\/jats:styled-content> scores (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01). Regarding the age\u2010matched subgroups only <jats:styled-content style=\"fixed-case\">HB<\/jats:styled-content> showed higher knee scores than <jats:styled-content style=\"fixed-case\">CB<\/jats:styled-content> (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05). The ankles were clinically more affected in <jats:styled-content style=\"fixed-case\">HB<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">HD<\/jats:styled-content> compared with those in age\u2010matched controls (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05). H showed lower quadriceps strength than C (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05). In addition, all subgroups of H presented lower strength (<jats:styled-content style=\"fixed-case\">HA<\/jats:styled-content>: 10\u201317, <jats:styled-content style=\"fixed-case\">HB<\/jats:styled-content>: 19\u201323, <jats:styled-content style=\"fixed-case\">HC<\/jats:styled-content>: 35\u201336, <jats:styled-content style=\"fixed-case\">HD<\/jats:styled-content>: 53\u201361; in%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05). <jats:styled-content style=\"fixed-case\">IED<\/jats:styled-content> was higher in H than in C [H: 12.0 (5.3\/32.2) vs. C: 7.1 (2.9\/10.9); Median (quartiles) in%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001] and increased with age in H. We discovered an <jats:styled-content style=\"fixed-case\">AIED<\/jats:styled-content> in 35% of H. These findings highlight the importance for the early implementation of preventive and rehabilitative muscle training programmes in the comprehensive treatment of <jats:styled-content style=\"fixed-case\">PWH<\/jats:styled-content>.<\/jats:p>","DOI":"10.1111\/hae.12034","type":"journal-article","created":{"date-parts":[[2012,10,11]],"date-time":"2012-10-11T14:05:39Z","timestamp":1349964339000},"page":"267-274","source":"Crossref","is-referenced-by-count":23,"title":["Quadriceps strength, inter\u2010extremity difference (<scp>IED<\/scp>) and joint status in adult persons with severe haemophilia in different age stages"],"prefix":"10.1111","volume":"19","author":[{"given":"A.","family":"Brunner","sequence":"first","affiliation":[{"name":"Department of Sports Medicine University of Wuppertal Wuppertal Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"St\u00e4uber","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine University of Wuppertal Wuppertal Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"G\u00f6hler","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine University of Wuppertal Wuppertal Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Czepa","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine University of Wuppertal Wuppertal Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Kr\u00fcger","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine University of Wuppertal Wuppertal Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Wendel","sequence":"additional","affiliation":[{"name":"Institute of Motion Analysis and Quality Control of the Locomotive System Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Seuser","sequence":"additional","affiliation":[{"name":"Institute of Motion Analysis and Quality Control of the Locomotive System Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Hilberg","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine University of Wuppertal Wuppertal Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,10,11]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2008.01876.x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2007.06490.x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2008.01732.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2516.2001.00563.x"},{"key":"e_1_2_8_6_1","first-page":"S97","article-title":"Maximal isometric strength measures of the quadriceps muscles. 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