Comparison of biomechanical gait parameters of young  children with haemophilia and those of age-matched peers.
Quality of life for children with haemophilia has improved since the introduction of prophylaxis. The frequency of joint haemorrhages has reduced, but the consequences of reduced bleeding on the biomechanical parameters of walking are not well understood. This study explored the differences in sagittal plane biomechanics of walking between a control group (Group 1) of normal age-matched children and children with haemophilia (Group 2) with a target ankle joint. A motion capture system and two force platforms were used to collect sagittal plane kinematic, kinetic and temporal-spatial data during walking of 14 age-matched normal children and 14 children with haemophilia aged 7-13 years. Group differences in maximum and minimum flexion/extension angles and moments of the hip, knee and ankle joints, ground reaction forces and temporal-spatial gait cycle parameters were analysed using one-way anova. Significant changes (P < 0.05) in kinematic and kinetic parameters but not temporal-spatial parameters were found in children with haemophilia; greater flexion angles and external moments of force at the knee, greater ankle plantarflexion external moments and lower hip flexion external moments. These results suggest that early biomechanical changes are present in young haemophilic children with a history of a target ankle joint and imply that lower limb joint function is more impaired than current clinical evaluations indicate. Protocols and quantitative data on the biomechanical gait pattern of children with haemophilia reported in this study provide a baseline to evaluate lower limb joint function and clinical progression.
School of Health and Bioscience, University of East London, London, UK.
D
D
Stephensen
W
W
Drechsler
M
M
Winter
O
O
Scott
D000293:Adolescent; D000704:Analysis of Variance; D001696:Biomechanical Phenomena / Q000502:physiology; D002648:Child; D018450:Disease Progression; D006467:Hemophilia A / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007592:Joint Diseases / Q000503:physiopathology*; D008297:Male; D011788:Quality of Life / Q000523:psychology; D016138:Walking / Q000502:physiology*