{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T23:13:23Z","timestamp":1790205203468,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2014,8,25]],"date-time":"2014-08-25T00:00:00Z","timestamp":1408924800000},"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":[[2014,11]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Impaired contraction steadiness of lower limb muscles affects functional performance and may increase injury risk. We hypothesize that haemophilic arthropathy of the knee and the strength status of quadriceps are relevant factors which compromise a steady contraction. This study addresses the questions if impaired steadiness of the quadriceps is verifiable in people with haemophilia (<jats:styled-content style=\"fixed-case\">PWH<\/jats:styled-content>) and whether a connection between the status of the knee joint and quadriceps strength exists. A total of 157 <jats:styled-content style=\"fixed-case\">PWH<\/jats:styled-content> and 85 controls (C) performed a strength test with a knee extensor device to evaluate their bilateral and unilateral maximal quadriceps strength and steadiness. Isometric steadiness was measured by the coefficient of variation of maximum peak torque (<jats:styled-content style=\"fixed-case\">CV<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">MVIC<\/jats:styled-content> in %). For classification of the knee joint status the World Federation of Haemophilia (<jats:styled-content style=\"fixed-case\">WFH<\/jats:styled-content>) score was used. Lower steadiness (higher <jats:styled-content style=\"fixed-case\">CV<\/jats:styled-content> values) was found in <jats:styled-content style=\"fixed-case\">PWH<\/jats:styled-content> compared with C during bilateral [<jats:styled-content style=\"fixed-case\">PWH<\/jats:styled-content> vs. C; 0.63 (0.36\/1.13) vs. 0.35 (0.15\/0.72), median (Q25\/Q75) <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001] and unilateral trials [left leg: 0.70 (0.32\/1.64) vs. 0.50 (0.23\/1.04), <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05; right leg: 0.68 (0.29\/1.51) vs. 0.39 (0.18\/0.68), <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001]. <jats:styled-content style=\"fixed-case\">PWH<\/jats:styled-content> with a <jats:styled-content style=\"fixed-case\">WFH<\/jats:styled-content> score difference (\u22651) between their extremities showed a less steady contraction in the more affected extremity (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05). More unsteady contractions have also been found in extremities with lower quadriceps strength compared with the contralateral stronger extremities (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), whereby the weaker extremities were associated with a worse joint status (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). The results of this study verify an impaired ability to realize a steady contraction of quadriceps in <jats:styled-content style=\"fixed-case\">PWH<\/jats:styled-content> and the influence of joint damage and strength on its manifestation.<\/jats:p>","DOI":"10.1111\/hae.12493","type":"journal-article","created":{"date-parts":[[2014,8,25]],"date-time":"2014-08-25T08:23:00Z","timestamp":1408954980000},"page":"884-890","source":"Crossref","is-referenced-by-count":9,"title":["Impact of joint status on contraction steadiness of m. quadriceps femoris in people with severe haemophilia"],"prefix":"10.1111","volume":"20","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":"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":[[2014,8,25]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2007.06490.x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2012.02909.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":"10.1111\/j.1365-2516.2010.02200.x"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2007.01613.x"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2516.2001.00563.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.12034"},{"key":"e_1_2_8_9_1","first-page":"97","article-title":"Maximal isometric strength measures of the quadriceps muscles. 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