The management of moderate hemophilia is less codified than those of severe patients; because these patients are theoretically less likely to bleed and therefore less likely to develop arthropathies. Nowaways, the question arises as to the appropriateness of this "symptomatic" management for the prevention of the occurrence of hemophilic arthropathies. Indeed, a significant number of moderate hemophiliacs seems to develop severe arthropathies that cause significant disability. However, because of the very small proportion of these patients in the total number of hemophiliacs, data are lacking on the impact of arthropathies on this population. The investigators therefore propose to include moderate hemophiliac patients in the study to carry out an evaluation of gait, using a gait analysis to determine the consequences of arthropathies, even sub-clinical ones, according to the duration of the disease's progression. In an associated way, the analysis of different clinical (joint assessment; quality of life score;...), radiological (radiographic; ultrasound (synovial thickness)), biological (level of associated factors ; other associated marker), in order to provide a complete picture of the articular situation in these patients with moderate haemophilia.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
PREVENTION
Masking
NONE
Enrollment
24
The duration of participation of each subject is equal to the duration of the examination, i.e. approximately 30 minutes for the gait analysis and 30 minutes for the clinical examination (including 10 minutes for completing the questionnaire). The experiments will be carried out in a single measurement session, including several steps.
Department of Physical Medicine and Locomotive Rehabilitation (Nantes University Hospital)
Nantes, France
Department of Physical Medicine and Neurological Rehabilitation (Nantes University Hospital)
Nantes, France
Regional Hemophilia Treatment Centre (Nantes University Hospital)
Nantes, France
Rheumatology department (Nantes University Hospital)
Nantes, France
Analysis of spatio-temporal parameters of the gait in moderate hemophiliac patients according to the duration of disease :
Analysis of gait parameters
Time frame: during gait analysis and clinical examination (1 hour)
Analysis of kinematic datas of the gait in moderate hemophiliac patients according to the duration of disease :
motion capture by optoelectronic system: articular amplitudes at different walking times
Time frame: during gait analysis and clinical examination (1 hour)
Analysis of dynamic datas of the gait in moderate hemophiliac patients according to the duration of disease :
accelerations measured by the force platforms during the passage of the subject: moments of force at the different joints during the different walking times
Time frame: during gait analysis and clinical examination (1 hour)
Calculation of the Gait profile Score (GPS)
As the Gait Profile Score represents the difference between the patient's data and the average from the reference dataset, the higher the Gait Profile Score value is, the less physiological gait pattern is.
Time frame: during gait analysis and clinical examination (1 hour)
Assessment of joint pain
pain (anlog visual scale from 0 (no pain) to 10 (maximal pain))
Time frame: during gait analysis and clinical examination (1 hour)
Assessment of joint health
Hemophilia Joint Health score (from 0 (best score) to 25 (worse score))
Time frame: during gait analysis and clinical examination (1 hour)
X-rays of target joints
Evaluated by Pettersson's score for hips, knees and ankles (score from 0 (normal score) to 10 (worse score))
Time frame: during gait analysis and clinical examination (1 hour)
Look for synovial hypertrophy by measuring the variation in synovial thickness of the ankles and knees
Ultrasound of knees and ankles
Time frame: during gait analysis and clinical examination (1 hour)
evaluation of bleeding and possible increase in synovial angiogenesis
Measure of doppler activity
Time frame: during gait analysis and clinical examination (1 hour)
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