IJPR.2025.133
Type of Article: Original Research
Volume 13; Issue 3 (September 2025)
Page No.: 4904-4911
DOI: https://dx.doi.org/10.16965/ijpr.2025.133
Effect of Sensorimotor Training Program on Balance and Gait in Patients with Haemophilia
Eric Merces Sousa 1, Sabah Thaver *1, Ali Irani 2.
1 Post Graduate Student, Department of Physiotherapy, Sunandan Divatia School of Science, SVKM’S NMIMS (Deemed To Be University), Vile Parle, Mumbai, India.
*1 Assistant Professor, Department of Physiotherapy, Sunandan Divatia School of Science, SVKM’S NMIMS (Deemed To Be University), Vile Parle, Mumbai, India.
2 Head of the department, Department of Physiotherapy, Nanavati Max Super speciality hospital, Vile Parle, Mumbai, India.
Corresponding author: Dr. Sabah Thaver, PT, Assistant Professor, Department of Physiotherapy, Sunandan Divatia School of Science, SVKM’S NMIMS (Deemed to Be) UNIVERSITY, Vile Parle, Mumbai, India. E-Mail: sabah.thaver@nmims.edu
ABSTRACT
Background: Haemophilia is a hereditary bleeding disorder that leads to recurrent joint bleeding (hemarthrosis), resulting in joint degeneration, muscle weakness, and proprioceptive impairments. These musculoskeletal deficits contribute to balance disturbances and abnormal gait patterns, increasing the risk of falls and mobility limitations in individuals with haemophilia. Despite advancements in medical management, rehabilitation strategies targeting neuromuscular and proprioceptive deficits remain underexplored.
Aims and Objectives: This study aimed to assess the effect of a sensorimotor training program on balance and gait in individuals with haemophilia. The specific objectives were to evaluate improvements in balance and gait parameters following a structured sensory-motor intervention.
Methodology: A total of 44 participants with haemophilia were recruited for an interventional study using a convenience sampling method. The study involved a four week sensorimotor training program consisting of flexibility exercises, balance training (sensory and motor components), core strengthening, and gait training. Outcome measures included the Single-Leg Stand Test (SLS), Timed Up and Go (TUG) test, and 2-Minute Walk Test (2MWT). Data were analysed using paired t-tests, with statistical significance set at p < 0.05.
Results: Significant improvements were observed post-intervention in all outcome measures. Single-leg stance times increased (Right leg: 15.30 ± 7.28 to 21.59 ± 9.13 sec, Left leg: 13.93 ± 6.04 to 21.07 ± 7.59 sec, p < 0.001). TUG test times decreased (25.35 ± 7.80 to 19.55 ± 6.69 sec, p < 0.001), indicating enhanced agility and dynamic balance. The 2MWT distances increased (140.11 ± 34.03 to 158.19 ± 34.99 meters, p < 0.001), reflecting improved walking endurance.
Conclusion: The sensorimotor training program produced statistically and clinically significant improvements in balance and gait in individuals with haemophilia. Enhanced proprioception, neuromuscular coordination, and postural control contributed to increased stability and functional mobility. These findings highlight the importance of incorporating sensorimotor training into standard physiotherapy care for haemophilia management.
Keywords: Haemophilia, Sensorimotor Training, Balance, Gait, Postural Stability, Proprioception, Functional Mobility, Fall Risk.
REFERENCES
[1]. Mehta P, Reddivari AKR. Hemophilia. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 [updated 2022 Jun 11; cited 2025 Jun 9]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551607/
[2]. Knobe K, Berntorp E. Haemophilia and joint disease: pathophysiology, evaluation, and management. J Comorb. 2011 Dec 27;1:51-9.
https://doi.org/10.15256/joc.2011.1.2
PMid:29090136 PMCid:PMC5556421
[3]. Calcaterra I, Iannuzzo F, Dell’Aquila G, Di Minno MN. Synovitis and hemophilic arthropathy: pathophysiological mechanisms and clinical implications. Front Physiol. 2020 Jun 5;11:541. doi:10.3389/fphys.2020.00541.
https://doi.org/10.3389/fphys.2020.00541
PMid:32581836 PMCid:PMC7296047
[4]. Flaherty LM, Schoeppe J, Kruse-Jarres R, Konkle BA. Balance, falls, and exercise: beliefs and experiences in people with hemophilia: a qualitative study. Res Pract Thromb Haemost. 2018;2(1):147-54.
https://doi.org/10.1002/rth2.12069
PMid:30046711 PMCid:PMC6055558
[5]. Truque Díaz C, Meroño Gallut J, Molina García C, Cuesta Barriuso R, Pérez Llanes R. Stability, balance, and physical variables in patients with bilateral hemophilic arthropathy of the ankle versus their healthy peers: a case-control study. Life (Basel). 2024 Aug 22;14(8):1051.
https://doi.org/10.3390/life14081051
PMid:39202791 PMCid:PMC11355264
[6]. Akbaş E, İnanır M. Evaluation of balance in children with hemophilia and the effect of balance on quality of life. Gait Posture. 2025 Mar;117:332-6.
https://doi.org/10.1016/j.gaitpost.2025.01.015
PMid:39842156
[7]. Wilkins RA, Stephensen D, Siddle HJ, Scott MJ, Xiang H, Horn E, et al. Twelve month prevalence of haemarthrosis and joint disease using the Haemophilia Joint Health Score: evaluation of the UK National Haemophilia Database and Haemtrack patient reported data: an observational study. BMJ Open. 2022 Jan 12;12(1):e052358.
https://doi.org/10.1136/bmjopen-2021-052358
PMid:35022172 PMCid:PMC8756269
[8]. Chimeno Hernández A, Querol Giner F, Pérez Alenda S, Núñez Cortés R, Cruz Montecinos C, Carrasco JJ, et al. Effectiveness of physical exercise on postural balance in patients with haemophilia: a systematic review. Haemophilia. 2022;28(3):409-21.
https://doi.org/10.1111/hae.14556
PMid:35363925 PMCid:PMC9325530
[9]. Timmer MA, Veenhof C, de Kleijn P, de Bie RA, Schutgens REG, Pisters MF. Movement behaviour in adults with haemophilia compared to healthy adults. Ther Adv Hematol. 2020;11:2040620719896959.
https://doi.org/10.1177/2040620719896959
PMid:32206245 PMCid:PMC7074509
[10]. Chen CM, Yang YH, Chang CH, Chen CC, Chen PC. The utilization of rehabilitation in patients with hemophilia A in Taiwan: a nationwide population-based study. PLoS One. 2016 Sep 30;11(9):e0164009.
https://doi.org/10.1371/journal.pone.0164009
PMid:27690229 PMCid:PMC5045205
[11]. Wagner B, Krüger S, Hilberg T, Ay C, Hasenoehrl T, Huber DF, et al. The effect of resistance exercise on strength and safety outcome for people with haemophilia: a systematic review. Haemophilia. 2020 Mar;26(2):200-15.
https://doi.org/10.1111/hae.13938
PMid:32091659 PMCid:PMC7155123
[12]. Boccalandro EA, Pasca S, Begnozzi V, Gualtierotti R, Mannucci PM. Joint dysfunction as a cause of spontaneous subclinical bleeding in infants with hemophilia. J Clin Med. 2023 Oct 12;12(20):6672.
https://doi.org/10.3390/jcm12206672
PMid:37892810 PMCid:PMC10607901
[13]. Matlary RED, Grinda N, Sayers F, Versloot O, McLaughlin P; EAHAD Physiotherapists Committee. Promoting physical activity for people with haemophilia in the age of new treatments. Haemophilia. 2022 Jul;28(8):e1-e6.
https://doi.org/10.1111/hae.14640
PMid:35921236
