Functional Independence Score in Haemophilia (Fish) for Children with Haemophilia: A Cross Sectional Study

Abstract

INTRODUCTION- Functional Independence Score in Haemophilia (FISH) is a performance-based assessment tool, to measure the patients' musculoskeletal functional ability. This study focuses on assessing the functional abilities of hemophiliac patients presenting to a tertiary care center.

MATERIAL METHODS- This hospital-based observational study was performed on 87 patients diagnosed with hemophilia. Patients between 4 to 18 years old were selected. Each patient was evaluated in seven activities under three categories: self-care (grooming and eating, bathing, and dressing), transfers (chair and squat), and locomotion (walking, running, and step climbing). Each activity was graded from 1 to 4 according to the amount of assistance required to perform the activity with total scores ranging from 7 to 28.

RESULTS- Patients in the majority belonged to the age group interval of 9-13 years, 11 months (36.8%) with a mean FISH of 29.44 in 4-8 year,11-month intervals with a maximum incidence of Haemophilia-A(91.95%). Mean FISH score was highest in cases of mild Haemophilia(31.66), and least in severe Haemophilia(24.05). Inhibitors and types of disease (Haemophilia-A and Haemophilia-B) were comparable with each other. Majority of cases belonged to score 4 in Eating and Grooming(81.6%), Dressing Score(43.7%), Chair Score(46%), Walking Score(60.9%), Stair score(40.2%), Running Score(31%). Squatting Score had the majority of cases in score 1(48.3%). Significant statistical difference was evident between severity and squatting, stair, and running scores (all p-values<0.001)

CONCLUSION- The functional components like squatting were affected depicting majorly knee joint involvement which was also statistically associated with severity.