Motor performance and disability in Dutch children with haemophilia: a comparison with their healthy peers.
We investigated whether haemophilic children who are on prophylactic therapy differ from their healthy peers in terms of motor performance and disability. Thirty-nine children, aged 4-12 years, with moderate (eight) and severe (31) haemophilia were included. Patients with severe haemophilia received primary prophylactic therapy that was individually tailored. The number of target joints, amount of swelling, range of motion, muscular strength and pain were measured, as well as motor skills and disability. The scores were compared to the normal population. No patients had target joints. Normal range of motion in all joints was seen in 97% (38/39) of the patients. Strength of elbow, knee, and ankle muscles were within the normal ranges. Ninety-five percent (37/39) of the patients had normal motor performance. Although 90% of our patients (35/39) had no disabilities in activities of daily living (ADL), 79% (31/39) of them reported that the disease impacted on their lives. Seventy-two percent (28/39) of the patients had pain, and in 21% (6/28) of them this was mainly caused by injections. Restrictions in sports or gymnastics were seen in 56% (22/39) of the patients. Those who indicated that they experienced pain and those who indicated restrictions in sports had a higher chance of experiencing disease impact compared to those who did not have these limitations. There were no significant differences between patients with moderate and severe haemophilia. In general, Dutch children with moderate or severe haemophilia are comparable with their healthy peers with regard to motor performance and ADL. However, a majority of the patients perceive an impact of their disease associated with pain and restrictions in sports.
Schoenmakers
M A
MA
Department of Paediatric Physiotherapy, Wilhelmina Children's Hospital, Utrecht, The Netherlands. m.a.g.c.schoenmakers@wkz.azu.nl
Gulmans
V A
VA
Helders
P J
PJ
van den Berg
H M
HM
D000843:Ankle Joint / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D004551:Elbow Joint / Q000503:physiopathology; D006173:Gymnastics / Q000502:physiology; D006467:Hemophilia A / Q000503:physiopathology*; D002836:Hemophilia B / Q000503:physiopathology; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D018908:Muscle Weakness / Q000209:etiology / Q000503:physiopathology; D009142:Musculoskeletal Physiological Phenomena; D009426:Netherlands; D010146:Pain; D011597:Psychomotor Performance; D011788:Quality of Life; D016059:Range of Motion, Articular; D012720:Severity of Illness Index