title: Evaluation of joint findings with gait analysis in children with hemophilia.
abstract: OBJECTIVE
  Hemophilic arthropathy due to recurrent joint bleeding leads to physical, psychological and socioeconomic problems in children with hemophilia and reduces their quality of life. The purpose of this study was to evaluate joint damage through various parameters and to determine functional deterioration in the musculoskeletal system during walking using kinetic and kinematic gait analysis.
  
  
  METHODS
  Physical examination and kinetic and kinematic gait analysis findings of 19 hemophilic patients aged 7-20 years were compared with those of age, sex and leg length matched controls.
  
  
  RESULTS
  Stride time was longer in the hemophilia group (p=0.001) compared to the age matched healthy control group, while hip, knee and ankle joint rotation angles were more limited (p=0.001, p=0.035 and p=0.001, respectively). In the hemophilia group, the extensor moment of the knee joint in the stance phase was less than that in the control group (p=0.001). Stride time was longer in the severe hemophilia group compared to the mild-moderate hemophilia and control groups (p=0.011 and p=0.001, respectively). Rotation angle of the ankle was wider in the control group compared to the other two groups (p=0.001 for both). Rotation angle of the ankle joint was narrower in the severe hemophilia group compared to the others (p=0.001 for each). Extensor moment of the knee joint was greater in the control group compared to the other two groups (p=0.003 and p=0.001, respectively). Walking velocity was higher in the control group compared to the severe hemophilia group.
  
  
  CONCLUSIONS
  Kinetic and kinematic gait analysis has the sensitivity to detect minimal changes in biomechanical parameters. Gait analysis can be used as a reliable method to detect early joint damage.
authors.affiliation: Ankara Children's Diseases and Hematology Oncology Hospital, Ankara, Turkey.
authors.forename: Atilla
authors.initials: A
authors.lastname: Cayir
authors.affiliation: Department of Physical Medicine and Rehabilitation, Haliç University, Istanbul, Turkey.
authors.forename: Gunes
authors.initials: G
authors.lastname: Yavuzer
authors.affiliation: Ankara Children's Diseases and Hematology Oncology Hospital, Ankara, Turkey.
authors.forename: Revide Tülin
authors.initials: RT
authors.lastname: Sayli
authors.affiliation: Department of Physical Medicine and Rehabilitation, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey.
authors.forename: Eda
authors.initials: E
authors.lastname: Gurcay
authors.affiliation: Ankara Children's Diseases and Hematology Oncology Hospital, Ankara, Turkey.
authors.forename: Vildan
authors.initials: V
authors.lastname: Culha
authors.affiliation: Department of Orthopedics and Traumatology Clinic, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Bozkurt
mesh_terms: D000293:Adolescent; D000843:Ankle Joint / Q000503:physiopathology*; D001696:Biomechanical Phenomena / Q000502:physiology; D002648:Child; D005260:Female; D005684:Gait / Q000502:physiology*; D006467:Hemophilia A / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D007592:Joint Diseases / Q000209:etiology / Q000503:physiopathology*; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D011788:Quality of Life; D016059:Range of Motion, Articular / Q000502:physiology*; D016138:Walking / Q000502:physiology; D055815:Young Adult
keywords: Child; arthropathy; gait; hemophilia