Gait analysis in children with haemophilia: first Italian experience at the Turin Haemophilia Centre

Abstract

Functional evaluation identified changes in gait pattern in patients with severe and moderate haemophilia, compared with normal values. Gait analysis may be a useful tool to facilitate early diagnosis of joint damage, prevent haemophilic arthropathy, design a personalized rehabilitative treatment and monitor functional status over time.

Clinical relevance of 3D gait analysis in patients with haemophilia

“…In case of clinically detectable arthropathy (association of clinical and X‐ray abnormalities), step length and velocity were significantly decreased and a significant increase was noticed in the swing time, stance time, step time, stride time, base of support, double and single support durations . Recently, Forneris et al confirmed that patients with moderate or severe haemophilia had a decrease in step speed and length and an increase in double support and swing phase duration. They provided sub‐group analysis showing that these results were most marked in patients with severe haemophilia receiving immune tolerance therapy and a current inhibitor.…”

“…Bladen et al provided only normalized data for velocity, which is a limit to their conclusions. Forneris et al analysed separately the left and the right sides but did not provide any clear information about the side of the target joints and their location. Sub‐group analyses were not performed according to the age, whereas spatiotemporal parameters highly depend on it .…”

“…Using our parameters of searches, we have identified 6 studies that have been conducted to determine the spatiotemporal parameters of walking in young PWH. 5,[15][16][17][18][19] Bladen et al found that boys with haemophilia had significant modifications of temporal walking parameters even if they were clinically asymptomatic. 15 In this study, boys with haemophilia were compared to age and leg lengthmatched controls.…”

Identifying biomechanical gait parameters in adolescent boys with haemophilia using principal component analysis

“…In addition, regular multi-joint investigation is expensive, time consuming and challenging in children due to Increasingly, motion capture technology is being used to evaluate movement disorders and provide details about mobility imperceptible to the naked eye. [2][3][4][5] Bladen et al, evaluated temporal spatial walking parameters using a GAITRite electronic walkway in 20 adolescent boys with severe haemophilia aged 7-17 years compared to age-matched control subjects and reported increased swing, reduced stance, increased single support times and reduced double support times in the group of boys with haemophilia. 3 Stephensen et al, evaluated 14 preadolescent boys with haemophilia aged 7-13 years with a history of ankle joint bleeding using a three-dimensional (3D) motion capture system and 2 force platforms and reported: greater flexion angles at the knee during early to mid-stance and swing phase of gait, greater external moments at the knee throughout stance, greater ankle plantarflexion external moments during early stance and lower hip flexion external moments during mid-stance.…”

“…Compared to normative reference data, children with haemophilia were found to walk with functional gait alteration. 4 Lobet et al, evaluated the walking patterns of 18 adults with haemophilia (aged 40 ± 10 years), reporting gradual infra-clinical alterations in temporal spatial, kinematic and kinetic parameters in those with advanced joint pathology. 5 Previous studies evaluating gait biomechanics in those with haemophilia 2,3,5 have evaluated parameterized values, such as maximum and minimum joint angles extracted at specific points of the gait cycle (eg, heel strike).…”