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Blood, 1 April 2004, Vol. 103, No. 7, pp. 2467-2473. Prepublished online as a Blood First Edition Paper on November 13, 2003; DOI 10.1182/blood-2003-05-1457. This Article Full Text (PDF) All Versions of this Article: 2003-05-1457v1 103/7/2467    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Soucie, J. M Articles by White, G. C Search for Related Content PubMed PubMed Citation Articles by Soucie, J. M Articles by White, G. C Related Collections Related Article in Blood Online Social Bookmarking                   What's this? Submitted May 8, 2003 Accepted November 4, 2003 Joint range of motion limitations among young males with hemophilia: prevalence and risk factors John M Soucie*, Christy Cianfrini, Robert L Janco, Roshni Kulkarni, Julie Hambleton, Bruce L Evatt, Angela Forsyth, Sue Geraghty, Keith Hoots, Tom Abshire, Randall Curtis, Ann Forsberg, Heather Huszti, Margaret Wagner, and Gilbert C White Hematologic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA Department of Pediatrics and Human Development, Michigan State University, East Lansing, MI, USA Division of Hematology/Oncology, University of California, San Francisco, CA, USA Penn Comprehensive Hemophilia Program, Presbyterian Medical Center, Philadelphia, PA, USA Mountain States Regional Hemophilia Center, Aurora, CO, USA Department of Pediatrics, University of Texas Health Sciences Center, Houston, TX, USA Pediatric HemOnc, Emory University School of Medicine, Atlanta, GA, USA Genetic Disease Branch, Department of Health Services, Berkeley, CA, USA New England Hemophilia Center, UMass Memorial Health Care, Worcester, MA, USA Department of Health Psychology, Children's Hospital of Orange County, Orange, CA, USA Christiana Care Health System, Newark, DE, USA Division of Hematology-Oncology, University of North Carolina, Chapel Hill, NC, USA * Corresponding author; email: msoucie{at}cdc.gov. Chronic joint disease from repeated bleeding into joints is a serious complication of hemophilia. To measure the extent of and to identify risk factors for joint range of motion (ROM) loss, we used cross-sectional data collected from 4,343 males with hemophilia aged 2-19 years who received care at 136 U.S. hemophilia treatment centers (HTCs). Factors examined included age, race/ethnicity, family history, insurance status, age at diagnosis and first HTC visit, frequency of HTC visits, hemophilia type, bleeding frequency, prophylaxis use, inhibitor status, body mass index (BMI), and recent orthopedic procedures. Trained personnel using a standard protocol obtained ROM measurements on 10 joints (hips, knees, shoulders, elbows, and ankles). Analyses used multiple linear regression to model overall ROM loss separately by disease severity. For persons in all severity groups, joint ROM loss was positively associated with older age, non-white race, and increased BMI. For those with severe disease, ROM loss was also positively associated with number of bleeds and was greater for those with inhibitors or recent orthopedic procedures. We conclude that ROM loss begins at an early age, especially for those with severe and moderate disease, and that BMI is an important, potentially modifiable risk factor for joint ROM loss. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Supple to stiff Arthur R. Thompson Blood 2004 103: 2433-2434. [Full Text] [PDF] This article has been cited by other articles: S. D. Grosse, M. S. Schechter, R. Kulkarni, M. A. Lloyd-Puryear, B. Strickland, and E. Trevathan Models of Comprehensive Multidisciplinary Care for Individuals in the United States With Genetic Disorders Pediatrics, January 1, 2009; 123(1): 407 - 412. [Abstract] [Full Text] [PDF] C. L. Kempton and G. C. 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