Brazilian Journal of Physical Therapy
Print version ISSN 1413-3555
GALANTE, GA et al. Evaluation of postural alignment and performance in functional activities among hemophilic children under 7 years old with and without chronic synovitis: correlation with hemarthrosis incidence. Rev. bras. fisioter. [online]. 2006, vol.10, n.2, pp. 171-176. ISSN 1413-3555. http://dx.doi.org/10.1590/S1413-35552006000200006.
INTRODUCTION: Synovitis associated with hemophilia may induce abnormalities in the proprioceptive and sensory receptors of joints. This favors decreased stability and body misalignment and may compromise the functional abilities of children affected by this condition. OBJECTIVE: To assess the lower limb postural alignment and functional performance of hemophilic children, and correlate this with the incidence of hemarthrosis. METHOD: An experimental group of 28 hemophilic children and a control group (CG) of 20 children without hemophilia were evaluated. The experimental group was divided according to the degree of joint involvement: 16 children without chronic synovitis (NCS) and 12 with chronic synovitis (CS). Each group was subdivided according to age groups: 3-4, 5-6 and 7 years old. The knee and ankle angle alignments were analyzed using the Geometer Sketchpad program. The children's performance in functional activities was evaluated using tests adapted from the Lefèvre evolutive neurological examination. RESULTS: In the experimental group, mean bleeding increased with age (p< 0.001) and seemed to be related to the degree of joint involvement (CS>NCS) (p< 0.059). In CS, the knee angle tended towards smaller values (semi-flexion), in comparison with other groups. There were significant differences in test performance among the seven-year-old groups (NSC>CG and NSC>CS) (p< 0.087). DISCUSSION AND CONCLUSION: The seven-year-old hemophilic children presented lower functional performance than did the other groups. This result emphasizes the importance of early physical therapy together with medical treatment, in order to avoid severe joint involvement.
Keywords : physical therapy; children; hemophilia; postural alignment; hemarthrosis.