A paper in the April issue of Blood detailed research on the prevalence and risk factors joint range of motion (ROM) limitation among young males with hemophilia.
Researchers collected data from more than 4,000 males with hemophilia between the ages of 2 and 19 who received care at 136 hemophilia treatment centers. ROM measurements were obtained on hips, knees, shoulders, elbows and ankles.
These measurements, taken into account with several other factors, like age, race, hemophilia type, prophylaxis use and body mass index (BMI), allowed the researchers to see that in all disease severity groups, ROM limitation was greater for patients who were older, were non white and those with a greater BMI. For those with severe hemophilia, ROM limitation increased with the number of bleeds and the presence of inhibitors or recent orthopedic procedures.
Those with factor VIII deficiency had a greater degree of ROM limitation than those who were factor IX deficient. The study’s analysis focused on ROM limitation that was accompanied by asymmetric joint mobility. “We conclude that ROM limitations begin at an early age, especially for those with severe and moderate disease, and that BMI is an important, potentially modifiable risk factor,” say the authors.
The authors note that current health recommendations for people with hemophilia include regular exercise using low-impact activities to increase muscle tone and strengthen joints. “An additional component that may be considered is routine monitoring of BMI,” the paper says.