Abstract Number: PB1041
Meeting: ISTH 2020 Congress
Background: 3D gait analysis has been proposed as a reproducible and valid method to assess abnormal gait patterns and to monitor disease progression in patients with hemophilia (PWH).
Aims: This study aimed at comparing Gait Deviation Index (GDI) between adult PWH and healthy controls, and at opposing further established and exploratory outcome measures of hemophilic athropathy.
Methods: Male PWH aged between 18 and 49 years on prophylactic replacement therapy, and male healthy age-matched controls, passed through a cross-sectional assessment battery. Besides the 3D gait analysis (Vicon, Oxford, UK) derived GDI, secondary outcomes included kinematic, kinetic and spatio-temporal gait parameters, the Hemophilia Joint Health Score (HJHS), and in an exploratory approach, an assessment of electric impedance derived leg muscle laterality and a combined joint damage biomarker score. The latter represents a panel of four biomarkers, which were suggested to reflect general joint damage (sCOMP, sC1,2C, sCS846, uCTX-II), averaged after z-standardization and transformation to percentile.
Results: PWH (n=18) walked slower, in shorter steps and accordingly with less functional range of motion in the hips and ankles, as opposed to healthy controls (n=24). However, PWH did not differ significantly in GDI, the majority of gait parameters, and the biomarker panel score. Median levels of CTX-II were in PWH 72% higher, though. PWH had a higher mean HJHS (18.8 vs. 2.6, p< .001) and leg muscle laterality (4.3 vs. 1.5%, p=.004). A subgroup analysis revealed progressed gait pathology in PWH aged 26 to 49 years. Leg muscle laterality was strongly correlated with HJHS (r=.76, p< .001), whereas GDI was not (r=-.39, p=.110).
Conclusions: General gait pathology (GDI) was found in PWH aged 26-49 years, but not so in those aged 18-25 years. Leg muscle laterality emerged as a promising approach in detecting progression and physiological consequences of hemophilic joint arthropathy.
To cite this abstract in AMA style:Putz P, Durstberger S, Kaufmann C, Klinger M, Widhalm K, Rejtö J, Male C, Pabinger I. 3D Gait Analysis, Hemophilia Joint Health Score, Leg Muscle Laterality, and Biomarkers of Joint Damage: A Cross-sectional Comparative Assessment of Hemophilic Arthropathy [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/d3d-gait-analysis-hemophilia-joint-health-score-leg-muscle-laterality-and-biomarkers-of-joint-damage-a-cross-sectional-comparative-assessment-of-hemophilic-arthropathy/. Accessed January 18, 2021.
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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/d3d-gait-analysis-hemophilia-joint-health-score-leg-muscle-laterality-and-biomarkers-of-joint-damage-a-cross-sectional-comparative-assessment-of-hemophilic-arthropathy/