The Role of Antigravity Treadmill in Haemophilic Children Aged 8 to 11 Years with Unilateral Knee Haemarthrosis without Radiological Involvement

Background: Recurrent joint bleeding in children with hemophilia leads to joint damage with pain, loss of range of motion and function. Antigravity treadmill (AGT) allows unloading of the lower extremities during exercise in a pressurized treadmill chamber.

Aim: To investigate the effect of AGT on muscle strength and functional balance in children with hemophilic knee arthritis.

Study Design: Prospective, randomized controlled study.

Place and Duration of Study: The outpatient clinic, Medical rehabilitation hospital, and King Fahd Hospital, Almadinah Almonawarah, Kingdom of Saudi Arabia, between January 2015 and Mars 2015.

Methods: Thirty hemophilic male children with unilateral knee heamarthrosis in the age ranged from 8 to 11 years old were randomly allocated into two equal groups. The control group (group A) received traditional exercise program, while the study group (group B) received AGT gait training added to the same exercise program of group A. Training was applied three times per week for twelve consecutive weeks. All children were assessed at baseline and after 36-session. Assessment included peak torque of quadriceps and hamstring muscles using Biodex Isokinetic Dynamometer and functional balance using Pediatric Berg balance scale (PBBS).

Results: Significant differences were observed in both groups when comparing their pre and post treatment mean values of all measuring variables (p<0.05). Peak torque of the quadriceps changed from (32.60±1.183, 32.933±1.533) to (38.40±1.681, 40.466±1.060) and peak torque of the hamstring changed from (25.00±1.81265, 25.933±2.0517) to (32.533±2.474, 35.933±2.631) for the control and study group respectively, indicating more improvement in favor of the study group. Both groups demonstrated a significant increase in functional balance, with more improvement in favor of group B.

Conclusion: It can be concluded that gait training using AGT may be used as a therapeutic intervention for improving muscle performance and functional balance in children with hemophilic knee arthritis. Although our sample was not large, the effect size was moderate to large (0.85 and 0.83) for the knee extensors and flexors respectively and 0.553 for PBBS.