Balance Evaluation in Adult Hemophilia

Static and dynamic balance assessments were performed using the Pro-kin Technobody Posturographic Platform (Pro-kin 212, Technobody s.r.l., Dalmine, 21044 Bergamo, Italy). Static balance was assessed using the "Static Stability Test." This test is based on the subject's oscillations on the force platform, assessing the movement of the center of pressure, and the trunk sensor measuring trunk oscillation. Dynamic balance will be assessed using the Limits of Stability test. For the LoS test, a medium difficulty level (20 levels) will be selected from the 5-10-20-30-40 difficulty levels. Participants will be asked to orient their center of gravity toward eight directional targets for a limited time.

This was assessed with Hemophilia Joint Health Score (HJHS). The HJHS evaluates the knee, elbow, and ankle index joints bilaterally and includes a walking score. Each joint can receive a maximum of 20 points, with a maximum walking score of 4 points (total score = 124). A higher score indicates poor joint health. Since the elbow joint score will not be used in this study, the maximum score was determined as 84.

Physical activity was evaluated with the International Physical Activity Questionnaire (IPAQ) Short Form. The IPAQ short form consists of seven questions to be answered by the patient and asks about the duration and frequency of each activity performed during the past week. The total score is calculated in MET-min/week by multiplying the MET values defined for walking (3.3 METs), moderate-intensity physical activity (4.0 METs), and vigorous-intensity physical activity (8.0 METs) by the duration (minutes) and frequency (days). Sitting is not included in the score. High scores indicate high physical activity.

Kinesiophobia will be assessed with the Tampa Scale for Kinesiophobia. Kinesiophobia is defined as the fear of reinjury and movement due to chronic pain. It consists of 17 questions, with total scores ranging 17-68. The higher the score is the gretaer the level of kinesiophobia, and scores above 37 are considered high kinesiophobia