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Muscle Strength in Children and Adolescents With Haemophilia on Prophylaxis: An Age-Adjusted Dynamometric Study

Dimitrios Syrengelas1, George Triantafyllou2, Aikaterini Michalopoulou3

  • 1Department of Pediatric Physical Therapy, "Aghia Sophia" Children's Hospital, Athens, Greece.

Haemophilia : the Official Journal of the World Federation of Hemophilia
|April 13, 2026
PubMed

Insights

Children with haemophilia (CwH) show reduced knee strength, especially in the non-dominant leg, even with prophylaxis. Early physiotherapy and strength monitoring are crucial for these children.

Area of Science:

  • Paediatric Orthopaedics
  • Sports Medicine
  • Haematology

Background:

  • Children with haemophilia (CwH) are susceptible to decreased muscle strength from joint bleeds and disuse.
  • Limited data exists on muscle strength in contemporary paediatric haemophilia populations receiving prophylaxis.

Purpose of the Study:

  • To assess the impact of haemophilia on muscle strength in children and adolescents.
  • To adjust for age when evaluating strength differences between children with haemophilia and healthy controls.

Main Methods:

  • Isometric dynamometry was used to measure elbow and knee flexion/extension strength in 34 boys with haemophilia and 25 healthy controls.
  • General linear models (GLM) analyzed strength variables, with age as a covariate and group as a factor.
  • Regression models further investigated age-adjusted strength differences.

Main Results:

  • Muscle strength showed a strong correlation with age in both groups.
  • GLM revealed significant effects of both age and group on strength.
  • Children with haemophilia exhibited significantly lower isometric strength in left-knee flexion and extension compared to controls, with age-adjusted deficits of -17.9 N and -26.6 N, respectively.

Conclusions:

  • Children with haemophilia demonstrate reduced isometric knee strength, particularly in the non-dominant limb, despite prophylactic treatment.
  • Individualized physiotherapy and consistent strength monitoring are recommended for early intervention in CwH.
  • Strength deficits tend to decrease with increasing age.
Abstract

Keywords:
haemophiliamuscle strengthpaediatric populationphysiotherapy

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