{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T13:19:24Z","timestamp":1772457564432,"version":"3.50.1"},"reference-count":40,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Sanofi Company","award":["TW20002"],"award-info":[{"award-number":["TW20002"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Hemophilia is an X-linked inherited bleeding disorder characterized by joint hemorrhages and progressive arthropathy. While mutation type is known to influence disease severity, its impact on postural balance strategies has remained unclear. This cross-sectional study investigated the relationship between gene mutation type and postural control in hemophilia A patient using center of pressure (CoP) analysis and radiographic joint assessment with the Pettersson score. Thirty-five participants were divided into an INV group (intron 22 or intron 1 inversion of the F8 gene) and a NonINV group (other mutations). While the Pettersson scores and traditional time-domain CoP parameters (sway area, velocity) were comparable between groups, frequency domain analysis revealed a significant difference. INV group exhibited significantly higher energy content above 2 Hz in the anteroposterior direction compared to NonINV group. This genotype-specific spectral signature emerged despite comparable radiographic arthropathy and conventional CoP metrics, suggesting that frequency-domain CoP analysis can uncover subclinical postural adaptations in hemophilia A. These findings highlight the need for targeted proprioceptive training in this specific subpopulation to prevent subclinical instability and potential falls.<\/jats:p>","DOI":"10.3390\/ijms27052323","type":"journal-article","created":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T12:39:56Z","timestamp":1772455196000},"page":"2323","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Genotype-Specific Postural Control Deficits in Hemophilia A: Insights from Center of Pressure Analysis Beyond Radiographic Arthropathy"],"prefix":"10.3390","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-6902-7815","authenticated-orcid":false,"given":"Ya-Chi","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Changhua Christian Hospital, Changhua 500, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei-Long","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of General Practice, Department of Medical Education, Changhua Christian Hospital, Changhua 500, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsuan-Yu","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Internal Medicine, Changhua Christian Hospital, Changhua 500, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8256-5782","authenticated-orcid":false,"given":"Peng-Ta","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Senior Wellness and Sport Science, Tunghai University, Taichung 407, Taiwan"},{"name":"Department of Senior Health and Exercise Science, Tunghai University, Taichung 407, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3706-0480","authenticated-orcid":false,"given":"Cheng-Wei","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Internal Medicine, Changhua Christian Hospital, Changhua 500, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7789-2148","authenticated-orcid":false,"given":"Ming-Ching","family":"Shen","sequence":"additional","affiliation":[{"name":"Hemophilia Treatment and Thrombosis Center, Department of Internal Medicine, Changhua Christian Hospital, Changhua 500, Taiwan"},{"name":"Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan"},{"name":"Department of Laboratory Medicine, National Taiwan University Hospital, Taipei 100, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5076-2917","authenticated-orcid":false,"given":"Ming","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Genomic Medicine, Changhua Christian Hospital, Changhua 500, Taiwan"},{"name":"Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua 500, Taiwan"},{"name":"Department of Medical Genetics, National Taiwan University Hospital, Taipei 100, Taiwan"},{"name":"Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei 100, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shun-Ping","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Genomic Medicine, Changhua Christian Hospital, Changhua 500, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adeline","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Genomic Medicine, Changhua Christian Hospital, Changhua 500, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shao-Li","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Changhua Christian Hospital, Changhua 500, Taiwan"},{"name":"Department of Physical Medicine and Rehabilitation, Kaohsiung Show Chwan Memorial Hospital, Kaohsiung 821, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,1]]},"reference":[{"key":"ref_1","first-page":"1","article-title":"Joint protection in haemophilia","volume":"17","author":"Aznar","year":"2011","journal-title":"Haemophilia"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1111\/j.1365-2516.2010.02245.x","article-title":"Natural progression of blood-induced joint damage in patients with haemophilia: Clinical relevance and reproducibility of three-dimensional gait analysis","volume":"16","author":"Lobet","year":"2010","journal-title":"Haemophilia"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Rodr\u00edguez-Merch\u00e1n, E.C. 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