# Exploring the Biomechanics of Joint Bleeding in Persons with Hemophilia to Better

> **NIH NIH K23** · UNIVERSITY OF COLORADO DENVER · 2023 · $187,492

## Abstract

PROJECT SUMMARY/ABSTRACT
 Hemophilia is an inherited deficiency of clotting factor VIII or IX, which causes joint bleeding and crippling
arthropathy, along with muscle bleeding. Prophylactic factor medication administered intravenously several
times per week decreases but does not eliminate bleeding. Most efforts to eliminate breakthrough bleeding on
prophylaxis alter medication regimens to increase factor levels; however, this is often not successful and comes
with increased financial burden and/or more frequent injections. The effort to eliminate breakthrough bleeding
is limited by an incomplete understanding of bleeding biomechanics. This knowledge gap also constrains
choices for safe and effective physical activity, which is important in persons with hemophilia (PwH) to prevent
obesity, improve social functioning, and decrease mental health concerns. This study develops methods to
objectively measure forces related to lower extremity joint and muscle bleeding in PwH, in order to fulfill
the long-term goal of decreasing bleeding risk. This long-term goal will be accomplished in a future study that
will collect data to build a time-dependent statistical model of bleeding risk that includes hemostatic, joint fragility,
and biomechanical bleeding risk components. The objectives of the current study are to determine how past
joint bleeding influences asymmetry in lower extremity joint loading, measured in a Motion Lab using motion
capture and force plate technology (aim 1); to determine the influence of motion lab asymmetry on future lower
extremity joint and muscle bleeding (aim 2); and to develop tools to collect motion data outside the Motion Lab
using inertial measurement units (IMUs) (aim 3).
 The immediate goals of the candidate for this K23 award, Dr. Beth Warren, are to add new skills to her
bioengineering and hematology background. These include motion measurement techniques inside and outside
the Motion Lab, including signal processing techniques; hemophilia joint outcome measurement and meaning;
and statistical model planning for future studies. Achieving these goals will support her long-term career goal to
become a leading expert in hemophilia joint outcomes and activity-associated bleeding risk.
 Dr. Warren will accomplish her research and training aims with the support of her mentors, Dr. Marilyn
Manco-Johnson (hemophilia clinical research) and Dr. James Carollo (biomechanics, movement analysis). The
University of Colorado Hemophilia and Thrombosis Center (UC-HTC) will provide world-class infrastructure to
support Dr. Warren’s career development and research objectives, including facilities and research staff with
extensive experience and expertise in hemophilia clinical research. The University of Colorado provides junior
faculty members with numerous opportunities to facilitate the transition to research career independence. By
completing her research and training aims, Dr. Warren will advance the science of objective measurement ...

## Key facts

- **NIH application ID:** 10558604
- **Project number:** 5K23HL151886-03
- **Recipient organization:** UNIVERSITY OF COLORADO DENVER
- **Principal Investigator:** Beth Boulden Warren
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $187,492
- **Award type:** 5
- **Project period:** 2021-02-19 → 2026-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10558604

## Citation

> US National Institutes of Health, RePORTER application 10558604, Exploring the Biomechanics of Joint Bleeding in Persons with Hemophilia to Better (5K23HL151886-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10558604. Licensed CC0.

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