Evaluation of Static Postural Balance in Children With Hemophilia and Its Relationship With Joint Health
Condition: Hemophilia; Arthropathy of Knee; Arthropathy of Ankle or Foot
MeSH terms: Joint Diseases; Hemophilia A
Study type: Observational [Patient Registry]

Summary: 
      Hemophilia is a rare hematological disorder characterized by a partial or complete deficiency
      of clotting factor VIII or IX.Bleeding disorders mainly affect the musculoskeletal system.
      Intra-articular bleeding is an important complication related to hemophilia and usually
      occurs in large synovial joints such as knees and ankles. Initially, these bleeds occur
      non-specific spontaneously and usually affect one joint, and repeated bleeding makes that
      joint a target joint. Postural balance can be defined as the ability to maintain a stable
      posture for maximum duration with minimal body sway, or to hold the body centre of gravity
      (CoG) over its base support in varying conditions (1). Somatosensorial information from
      mechanoreceptors, visual and vestibular receptors is required to maintain postural balance.
      Postural balance is tried to be controlled by the postural adjustments provided by the
      contraction of the lower limb muscles and trunk muscles before perturbation. Spontaneous
      hemarthrosis is a distinctive feature of severe haemophilia, and that recurrent bleedings may
      likely to cause postural balance disorders by disrupting proprioceptive inputs from
      mechanoreceptors in the joint. Data on how bleeding affects postural balance in children with
      hemophilia is unclear.In the relationship between the clinical evaluation of hemophilia and
      postural balance, there is little research in the literature.
    

Detailed description: 
      The aim of this study was to investigate the changes in static postural balance parameters
      more reliably and comprehensively with a longer test duration and to reveal the relationship
      between balance parameters and joint health score in children with hemophilia. The
      investigator's hypothesis was that in children with hemophilia (CwH), postural balance was
      correlated with joint health status and had poor static postural balance compared to healthy
      peers.

      Twenty-one CwH aged 6 to 18 years who developed hemophilic arthropathy in at least one of the
      lower limb joints due to severe hemophilia and twenty-one healthy peers were included in the
      study.

      The Hemophilia Joint Health Score (HJHS), a valid and reliable test, was used to measure the
      joint health in CwH. Muscle strengths were measured with digital dynamometer. The kinetic
      devices most commonly used to evaluate in the laboratory evaluation of postural balance are
      the force platform and are considered the gold standard method. In the postural balance
      evaluation, changes in the X and Y axis were used. The amplitude of these changes, the
      standard deviation of the displacement, and the velocity were evaluated. In addition, the
      ellipse area and perimeter were measured.
    

Observational model: Case-Control
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Hemophilic children in Van province
      
Keywords: haemophilia; balance; joint health; arthropathy; children