Gait Analysis in Moderate Hemophiliac Patients (AQM-Hemophile)

Study Overview
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Brief Summary
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The management of moderate hemophilia is less codified than those of severe patients; because these patients are theoretically less likely to bleed and therefore less likely to develop arthropathies. Nowaways, the question arises as to the appropriateness of this symptomatic management for the prevention of the occurrence of hemophilic arthropathies. Indeed, a significant number of moderate hemophiliacs seems to develop severe arthropathies that cause significant disability. However, because of the very small proportion of these patients in the total number of hemophiliacs, data are lacking on the impact of arthropathies on this population. The investigators therefore propose to include moderate hemophiliac patients in the study to carry out an evaluation of gait, using a gait analysis to determine the consequences of arthropathies, even sub-clinical ones, according to the duration of the disease's progression. In an associated way, the analysis of different clinical (joint assessment; quality of life score;...), radiological (radiographic; ultrasound (synovial thickness)), biological (level of associated factors ; other associated marker), in order to provide a complete picture of the articular situation in these patients with moderate haemophilia.

Official Title
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Study of the Parameters of Quantified Gait Analysis in Moderate Hemophiliac Patients (AQM-Hemophile)

Conditions
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Moderate Hemophilia, Arthropathy

Intervention / Treatment
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* Other: Gait analysis


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Have moderate Hemophilia A or B. Have understood the protocol and signed its consent to participate. Patient able to perform a walking test. Patient affiliated to a social security system Exclusion Criteria: Pregnant women Minor Majors under guardianship or curatorship Refusal to participate; Amputee of a lower limb Need for technical walking assistance (walking sticks, walker,...). Extensive dermatitis of the lower limbs (need for sensor installation for gait analysis); Known NYHA (New York Heart Association) grade III or IV heart failure (resting dyspnea); Unstable angina or myocardial infarction within three months of inclusion Known severe respiratory disease; Parkinson's disease, hemiplegia or paraplegia Patient unable to understand the objectives or instructions of the study Intercurrent pathology likely to modify walking abilities

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Intervention Model: Single Group Assignment
Interventional Model Description: Each participant will perform the quantified gait analysis examination and a clinical examination. The experiments will be carried out in a single measurement session, including several steps.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Moderate hemophiliac patients<br>Each participant will perform a gait analysis and clinical examination | Other: Gait analysis<br>* The duration of participation of each subject is equal to the duration of the examination, i.e. approximately 30 minutes for the gait analysis and 30 minutes for the clinical examination (including 10 minutes for completing the questionnaire). The experiments will be carried out in a single measurement session, including several steps.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Analysis of spatio-temporal parameters of the gait in moderate hemophiliac patients according to the duration of disease : | Analysis of gait parameters | during gait analysis and clinical examination (1 hour) | 
| Analysis of kinematic datas of the gait in moderate hemophiliac patients according to the duration of disease : | motion capture by optoelectronic system: articular amplitudes at different walking times | during gait analysis and clinical examination (1 hour) | 
| Analysis of dynamic datas of the gait in moderate hemophiliac patients according to the duration of disease : | accelerations measured by the force platforms during the passage of the subject: moments of force at the different joints during the different walking times | during gait analysis and clinical examination (1 hour) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Calculation of the Gait profile Score (GPS) | As the Gait Profile Score represents the difference between the patient's data and the average from the reference dataset, the higher the Gait Profile Score value is, the less physiological gait pattern is. | during gait analysis and clinical examination (1 hour) | 
| Assessment of joint pain | pain (anlog visual scale from 0 (no pain) to 10 (maximal pain)) | during gait analysis and clinical examination (1 hour) | 
| Assessment of joint health | Hemophilia Joint Health score (from 0 (best score) to 25 (worse score)) | during gait analysis and clinical examination (1 hour) | 
| X-rays of target joints | Evaluated by Pettersson's score for hips, knees and ankles (score from 0 (normal score) to 10 (worse score)) | during gait analysis and clinical examination (1 hour) | 
| Look for synovial hypertrophy by measuring the variation in synovial thickness of the ankles and knees | Ultrasound of knees and ankles | during gait analysis and clinical examination (1 hour) | 
| evaluation of bleeding and possible increase in synovial angiogenesis | Measure of doppler activity | during gait analysis and clinical examination (1 hour) |