Persons with high Hemophilia Joint Health Scores have reduced functional range of motion during simulated sports activities

Background: Joint bleeds for persons with hemophilia are characteristic and can lead to hemophilic arthropathy, primarily in the ankles, knees, and elbows. The Hemophilia Joint Health Score (HJHS) is a validated physical exam measure of hemophilic arthropathy but does not take into account functional range of motion (ROM). Objectives: To examine the association between HJHS severity and functional ROM during simulated sports activities in persons with hemophilia compared with healthy controls. Methods: Using motion capture analysis, functional ROM at the ankle, knee, and hip was measured in 86 persons with hemophilia A or B and 33 healthy controls while performing 10 simulated sports activities. Comparisons of functional ROM were made across 5 groups (1 control and 4 hemophilia groups based on total 6-joint HJHS) using Jonckheere-Terpstra and Kolmogorov-Smirnov post hoc analyses. Results: Persons with hemophilia who had a total 6-joint HJHS ≥25 demonstrated reduced functional ROM compared with controls, most notably at the ankle, where significant reductions were observed in 8 of 10 activities. Persons with hemophilia who had a total 6-joint HJHS