Joint Health, Balance and Quality of Life in Adults With Hemophilia A

NCT07523399 | Recruiting

• 1 other identifier: YuzuncuYil2026-QoL
• Study Type: observational
• Target: 36
• Locations: 1 country
• Sites: 1

Brief Summary

Hemophilia is a hereditary bleeding disorder characterized by recurrent bleeding episodes, particularly into joints and muscles, leading to chronic musculoskeletal complications. Repeated joint bleeding may result in hemophilic arthropathy, which is associated with progressive joint damage, chronic pain, reduced mobility, and functional limitations. Advances in prophylactic treatment have significantly improved life expectancy in individuals with hemophilia; however, long-term musculoskeletal complications continue to affect daily functioning and overall well-being. Therefore, the evaluation of health-related quality of life (QoL) has become increasingly important in adults with hemophilia, as it reflects the broader impact of the disease beyond clinical severity. Joint health is considered one of the major determinants of physical functioning in people with hemophilia. Hemophilic arthropathy may lead to chronic pain, muscle weakness, reduced range of motion, and impaired physical performance. In addition to structural joint changes, impairments in neuromuscular function, including reduced proprioception, muscle strength, and postural control, may also contribute to activity limitations. Balance impairments may increase the risk of falls, which may be particularly relevant for individuals with hemophilia because fall-related trauma can lead to bleeding episodes and further joint deterioration. Although previous studies have investigated the relationship between joint health, pain, and functional limitations, the combined contribution of joint health, pain severity, dynamic balance performance, and fall history to QoL in adults with hemophilia has not been sufficiently clarified. This prospective cross-sectional study aims to evaluate QoL in adults with hemophilia and to investigate the associations of joint health, pain severity, dynamic balance performance, and fall history with QoL outcomes. The study includes 36 adults diagnosed with severe hemophilia A who are followed at the Adult Hematology Unit of Van Yuzuncu Yil University. Participants aged 18 years and older who met the inclusion criteria were recruited consecutively. Individuals using walking aids, having neurological or psychiatric disorders, chronic inflammatory diseases, recent lower extremity surgery, or regular medication use that could affect balance were excluded. Joint health is assessed using the Hemophilia Joint Health Score (HJHS), a clinician-administered tool evaluating joint impairment in the knees and ankles. Dynamic balance is assessed using a computerized stabilometric platform (Pro-kin Tecnobody Stabilometric Analysis System) with the Limits of Stability (LoS) test, which evaluates the ability to voluntarily control the center of pressure within the base of support. Pain intensity is measured using the Numeric Pain Rating Scale (NPRS), an 11-point scale ranging from 0 to 10. Fall history is determined based on the self-reported number of falls within the previous 12 months. QoL is assessed using the Turkish version of the Haemophilia-Specific Quality of Life Questionnaire for adults (Haem-A-QoL), a validated patient-reported outcome measure evaluating multiple domains of physical, emotional, and social well-being. Higher scores indicate poorer QoL. The findings of this study are expected to improve the understanding of factors associated with QoL in adults with hemophilia and may help identify potentially modifiable clinical targets for rehabilitation interventions.

Conditions

Hemophilia A

Keywords

Quality of life; Hemophilia A; Arthropathy; Postural balance; Falls; Musculoskeletal Pain

Outcome Measures

Primary Outcomes (3)

• Health-related quality of life

  Health-related quality of life will be assessed using the Haemophilia-Specific Quality of Life Questionnaire for Adults (Haem-A-QoL). The total score ranges from 0 to 100, with higher scores indicating poorer quality of life.

  Baseline

• Joint Health

  Joint health will be evaluated using the Hemophilia Joint Health Score (HJHS). Higher scores indicate poorer joint health status.

  Baseline

• Postural Balance

  Dynamic postural balance were evaluated with the Pro-kin Technobody Posturographic Platform (Pro-kin 212, Technobody s.r.l, Dalmine, 21044 Bergamo, Italy).

  Baseline

Secondary Outcomes (2)

• Musculoskeletal Pain

  Baseline

• Falls

  Baseline

Study Arms (1)

Hemophilia A

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: male
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Adults with hemophilia A

You may qualify if:

• Diagnosis of severe hemophilia A
• Age ≥18 years
• A minimum single-joint score of 3 points for the knee or ankle according to the Hemophilia Joint Health Score (HJHS)

You may not qualify if:

• Use of walking aids (e.g., crutches)
• Presence of neurological or psychiatric disorders, chronic inflammatory disease, -Regular use of medications that could affect balance,
• History of major lower extremity surgery within the previous six months.

Sponsors & Collaborators

• Yuzuncu Yil University: lead

Study Sites (1)

Van Yuzuncu Yil University

Van, 65080, Turkey (Türkiye)

RECRUITING

MeSH Terms

Conditions

Hemophilia A; Joint Diseases; Musculoskeletal Pain

Condition Hierarchy (Ancestors)

Blood Coagulation Disorders, Inherited; Blood Coagulation Disorders; Hematologic Diseases; Hemic and Lymphatic Diseases; Coagulation Protein Disorders; Hemorrhagic Disorders; Genetic Diseases, Inborn; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Musculoskeletal Diseases; Muscular Diseases; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Central Study Contacts

Ayse Merve Tat, Assistant Professor

CONTACT

+905052431112; aysemervetat@yyu.edu.tr

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: CROSS SECTIONAL
• Target Duration: 2 Weeks
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Study Record Dates

• First Submitted: April 4, 2026
• First Posted: April 13, 2026
• Study Start: February 21, 2026
• Primary Completion: April 21, 2026
• Study Completion (Estimated): May 21, 2026
• Last Updated: April 13, 2026

Record last verified: 2026-04

Locations

TU (1)