Gait Pattern at Different Speeds in Persons With Haemophilia.

INTRODUCTION

Persons with haemophilia (PwH) have a risk of bleeding in joints, especially in elbow, knee and ankle. In the long term, this leads to haemophilic arthropathy (HA), which results in joint deformities.

AIM: This study aims to examine how walking speed and HA affect (1) foot pressure distribution, (2) average vertical peak pressure, and (3) knee and ankle joint angles during walking.

METHODS

Using a motion analysis system (DIERS 4DmotionLab), 30 PwH and 31 healthy controls (CG) were examined at speeds of 3, 4, and 5 km/h. Groups were additionally divided according to the severity of HA, in the subgroups PwH(major) and PwH(minor).

RESULTS

Regarding different gait speeds, no differences were found between PwH and CG in peak pressure distribution. However, pedobarography showed a significant reduction in average vertical peak pressure in the second half of the stance phase in PwH(major) compared to CG (p < 0.007). Joint angle measurements showed reduced plantar flexion (p = 0.041), dorsiflexion (p = 0.011), and descriptive, non-significant knee flexion in PwH(major) at different speeds. Knee extension did not differ between groups.

CONCLUSION

The study confirms that PwH, especially those with advanced HA, show impaired gait pattern. While different walking speeds had no impact on peak pressure values compared to CG, force transmission was reduced in PwH in the second half of the stance phase. This, in conjunction with reduced mobility in the ankle joints, indicates impaired power transmission in the propulsion phase which is well compensated.