Gross motor testing is recommended as part of the annual physical therapy evaluation for patients with hemophilia

A single center study shows gross motor delays in hemophilia boys between ages 4-14 years

NHF 2017 (Chicago, IL August 24-26): In a poster titled Prevalence of gross motor delays in boys with hemophilia ages 4-14: a single site study presented at the annual National Hemophilia Foundation (NHF) meeting, the authors looked at whether or not gross motor delays may be missed during the annual physical therapy evaluation of young boys with hemophilia. Gross motor skills are involved in movement and coordination of the arms, legs, and other large body parts and movements. Gross motor skills are important to participate in actions such as running, swimming, etc. Fine motor skills are involved in smaller movements that occur in the wrists, hands, fingers, and the feet and toes. Over a one-year period, the gross motor skills of 42 boys with hemophilia A or B from the ages of 4 to 14 were tested by a physical therapist using a valid and reliable test that assess upper extremity coordination, bilateral coordination, balance, strength, and running speed/agility.  The boys were divided into three age groups: Group 1 (4-7 year olds), group 2 (8-11 year olds) and group 3 (12-14 year olds). The average (mean) scores for each age group were within normal range except for the assessment of strength in group 2 (8-11 year olds). For group 1, 6-18% of the boys scored below average on 4 of the 5 subtests, while for group 2, 27-47% scored below average on all 5 subtests.  For group 3, 30-50% scored below average on all 5 subtests. These results suggest that at this HTC, more than 50% of the tested boys had gross motor delays that were apparent with this more detailed physical therapist assessment, with the percentage of boys that have deficits increasing and remaining an issue in children ages 7 and above.  The authors concluded that standardized gross motor testing should be included in the annual physical therapy evaluation of patients with hemophilia.