title: Hemophilia joint health score reliability study.
abstract: Measurement of joint health is critically important when assessing children with haemophilia. Few measures exist; they lack sensitivity to small changes, don't account for normal development and were never formally validated. To address these concerns, the Hemophilia Joint Health Score (HJHS) was developed by modifying existing scores.
  
  
  OBJECTIVE
  To test the inter-observer and test-retest reliability of the HJHS.
  
  
  METHODS
  Using a fully factorial design, four physiotherapists (from Canada, the United States and Sweden) examined eight boys with severe haemophilia A on two consecutive days using the HJHS. The boys ranged in age from 4-12 years and presented with variable joint damage. Six index joints (elbows, knees and ankles) were assessed on 11 impairment items including swelling, flexion and extension loss and gait. Concordance was measured by the intra-class correlation co-efficient.
  
  
  RESULTS
  Reliability of the HJHS was excellent with an inter-observer co-efficient of 0.83 and a test-retest of 0.89.
  
  
  CONCLUSIONS
  This study is the first in a series to assess the psychometric properties of the HJHS, a promising new measure of joint health in boys with haemophilia.
authors.affiliation: Department of Rehabilitation Service, the Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Canada. pamela.hilliard@sickkids.ca
authors.forename: P
authors.initials: P
authors.lastname: Hilliard
authors.forename: S
authors.initials: S
authors.lastname: Funk
authors.forename: N
authors.initials: N
authors.lastname: Zourikian
authors.forename: B-M
authors.initials: BM
authors.lastname: Bergstrom
authors.forename: C S
authors.initials: CS
authors.lastname: Bradley
authors.forename: M
authors.initials: M
authors.lastname: McLimont
authors.forename: M
authors.initials: M
authors.lastname: Manco-Johnson
authors.forename: P
authors.initials: P
authors.lastname: Petrini
authors.forename: M
authors.initials: M
authors.lastname: van den Berg
authors.forename: B M
authors.initials: BM
authors.lastname: Feldman
mesh_terms: D000843:Ankle Joint / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D004551:Elbow Joint / Q000473:pathology; D005684:Gait; D006467:Hemophilia A / Q000150:complications / Q000473:pathology*; D006801:Humans; D007592:Joint Diseases / Q000209:etiology / Q000473:pathology*; D007719:Knee Joint / Q000473:pathology; D008297:Male; D015588:Observer Variation; D026741:Physical Therapy Modalities; D015203:Reproducibility of Results