Brief Title
Evaluation of Static Postural Balance in Children With Hemophilia and Its Relationship With Joint Health
Official Title
Static Postural Balance Evaluation in Children With Severe Haemophilia and Investigation of Its Relationship With Joint Health: a Cross-sectional Study
Brief 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.
Study Type
Observational [Patient Registry]
Primary Outcome
Hemophilia Joint Health Score
Condition
Hemophilia
Study Arms / Comparison Groups
Hemophilia Group
Description: The inclusion criteria in the hemophilia group were as follows; patients aged 6 to 18 years who developed HA in at least one of the lower limb joints due to severe haemophilia (total lower limb HJHS ≥3); to be receiving prophylaxis but have no major bleeding that could affect the musculoskeletal system in the past two weeks; and who did not perform regular physical activity and sports.
Publications
* Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.
Recruitment Information
Estimated Enrollment
42
Start Date
February 1, 2018
Completion Date
May 15, 2019
Primary Completion Date
July 1, 2018
Eligibility Criteria
Inclusion Criteria:
- Aged 6 to 18 years
- Participants do not perform regular physical activity and sports.
- For hemophilia group who developed hemophilic arthropathy in at least one of the lower
limb joints due to severe hemophilia (total lower limb hemophilia joint health score
≥3).
- For hemophilia group patients to be receiving prophylaxis but have no major bleeding
that could affect the musculoskeletal system in the past two weeks
Exclusion Criteria:
- Have any auditory and visual impairment
- Undergo any orthopedic injuries including lower limb
- Have any neurological or cognitive disorders
Gender
Male
Ages
6 Years - 18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Contacts
Ahmet Fayik Oner, Prof., ,
Location Countries
Turkey
Location Countries
Turkey
Administrative Informations
NCT ID
NCT04406519
Organization ID
Necmettin Erb. Physiotherapy-3
Responsible Party
Principal Investigator
Study Sponsor
Necmettin Erbakan University
Study Sponsor
Ahmet Fayik Oner, Prof., Study Chair, Van Yuzuncu Yil University Faculty of Medicine Dept of Pediatric Hematology
Verification Date
May 2020