Measurement of gait variability in patients with and without hemophilic arthropathy; MOVE study

PROBLEM DEFINITION: Musculoskeletal assessment is necessary to evaluate efficacy of coagulation factor replacement therapy in hemophilia. Most current tools do not integrate the global impact of multiple-joint arthropathy or muscle bleeds. A new and simple sensor based gait analysis device measures and detects changes in gait pattern. This can serve as a screening tool in hemophilia patients with and without arthropathy.

OBJECTIVE: To establish whether this system can be used to detect gait abnormalities in hemophilia patients

STUDY DESIGN: Single-center cross sectional observational study

STUDY POPULATION: Hemophilia A or B patients with all severities

FEASIBILITY OF THE PROJECT: With 300 hemophilia patients in our Hemophilia Treatment Center and an annual visit of each patient, more than 100 patients can be included.

RELEVANCE FOR CLINICAL PRACTICE

A. CONCRETE REVENUES:

1. Simple and quick diagnostic and monitoring tool to evaluate joint status

2. Possibility to detect a disturbed gait in clinically asymptomatic patients

B. IMPLEMENTATION OF RESULTS:

If this sensor based gait analysis system shows to be an effective tool, we plan to implement this type of gait analysis in our regular hemophilia care; i.e. annual analysis.

- A new sensorbased gait analysis measurement as a simple and quick diagnostic/monitoring tool to evaluate joint status and changes in gait pattern in hemophilia patients.

- Possibility to detect a disturbed gait pattern in clinically asymptomatic patients (HJHS=0)

Because of the cross-sectional design of this study, every patient will be measured once. No follow-up intended.

Gait analysis with a new, simple and quick device. The six sensors of this system will be mounted on both sides of the hip, on the lateral side of the lower limbs using straps around thigh (just below the greater trochanter) and calf (at the level of the belly of the gastrocnemius muscle). Each patient will be asked to walk at least 20 meters on his own shoes, on standardized shoes and barefoot (grip socks for hygiene). The analysis of the walking test will be done using dedicated software. The analysis will be performed on the section of the walking test where the patient is walking steadily for at least 7 strides.

A physiotherapist specialized in hemophilia care will assess the Hemophilia Joint Health Score (HJHS) on the same day as the walking test. The results of the walking test will not be available to the physiotherapist and the HJHS assessment will not be available to the walking test executive.
Baseline data, data on hemophilia and joint history will be obtained by using questionnaires and patient history.