Evaluation of balance in children with hemophilia and the effect of balance on quality of life

Abstract

Background

Repeated joint bleeds are reported to decrease static balance in children with hemophilia (CwH).

Research question

Is dynamic balance affected in CwH? Does dynamic balance affect the quality of life in these patients?

Methods

This cross-sectional study included thirty male children aged 7–18 years diagnosed with hemophilia, along with thirty healthy male children as controls. Dynamic balance was evaluated using the limits of stability (LOS) test and a fall risk test, both conducted via the Biodex Balance System. The quality of life for the hemophilia group was measured using the Hemophilia-Specific Quality of Life Index (Haemo-QoL). The results of the LOS test were compared between the groups using Student’s t-test, and the fall risk test was undertaken with the Mann-Whitney U test. Correlations between balance assessments and Haemo-QoL scores were determined using Spearman’s correlation test.

Results

The median age was 13 years (interquartile range [IQR]=8) in the hemophilia group and 15 years (IQR=8) in the control group, with no significant age difference (p = 0.952). The hemophilia group scored significantly lower on LOS overall (p = 0.016), backward (p = 0.041), backward/right (p = 0.025), and backward/left (p = 0.005) measures. Fall risk scores were significantly higher in the hemophilia group (p = 0.024). LOS overall and fall risk scores had no correlation with Haemo-QoL scores (p = 0.583 and p = 0.805, respectively).

Significance

CwH exhibit reduced dynamic balance and an increased risk of falls compared to their healthy peers. However, dynamic balance appears to have no significant effect on quality of life in this group. These findings may guide the planning of rehabilitation programs for CwH.