Clinical Evaluation of Balance in Children With Hemophilic Arthropathy

Abstract

Purpose: Hemophilia is a hereditary coagulation disorder characterized by acute hemorrhages into the musculoskeletal system, leading eventually to arthropathy and disability. Chronic inflammation of the synovial membrane arises as a result of frequent joint hemorrhage. Proteolytic enzymes in the blood and cartilage cause deterioration after that, and joint space narrows. Chronic hemophilic arthropathy develops as a result of these unfavorable developments, which occur more quickly, especially in the target joints. Balance is a process that allows us to maintain our orientation in three-dimensional space while also regulating our body posture to avoid falling. After the central nervous system evaluates deep stimuli from sensory, visual, and auditory receptors, movement of the corresponding muscle groups is delivered.

Methods: The goal of this study was to investigate how impairment to deep sensory receptors (proprioception) in the arthropathic joint structure affected hemophiliacs' balance. The study comprised 34 patients with hemophilic arthropathy, and 34 age and weight matched healthy volunteers.

Results: When balance tests of patients with hemophilic arthropathy were compared to healthy controls, hemophiliacs had a greater risk of falling. As the degree of arthropathy increased, so did the risk of falling and balance test values in individuals with hemophilic arthropathy.

Conclusions: Treatment and coagulation factor prophylaxis to prevent the onset of arthropathy will improve patients' quality of life and reduce morbidity associated with frequent falls and bleeding.

Supplementary information: The online version contains supplementary material available at 10.1007/s12288-022-01526-0.

Keywords: Balance; Dynamic balance; Functional balance; Hemophilia; Hemophilic arthropathy; Static balance.

Fig. 1

(a) Comparison of Pediatric Berg Balance scores by severity of arthropathy (Gilbert score) (b) Comparison of TU> times by severity of arthropathy (Gilbert score)