Musculoskeletal Health (Formerly Physical Therapy)

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Dr. Sharon McHugh Funk
PT, DPT

Sharon has been treating persons with hemophilia for over 41 years, and was a founding member of the National Hemophilia Foundation’s (now the National Bleeding Disorders Foundation -NBDF) Physical Therapy Working Group. She developed the joint evaluation tool for the Joint Outcome Study; a prospective, randomized study comparing the joint outcomes of young boys with hemophilia on primary prophylaxis versus those receiving on-demand therapy. She has been involved in the development and psychometric testing confirming the reliability and validity of the Hemophilia Joint Health Score. (HJHS), an impairment measure for evaluating joint disease in hemophilia.
She is currently the co-chair of the Musculoskeletal Health Expert Working Group of the Hemophilia International Prophylaxis Study Group, of which she has been a member for the past 21 years. She is a member of the American Physical Therapy Association, the National Bleeding Disorders Foundation (NBDF) and the World Federation of Hemophilia Musculoskeletal Committee. In 1997, she was the recipient of the first NHF Physical Therapist of the Year Award and in 2001 she received the National Hemophilia Foundation Physical Therapy Excellence Fellowship.

Key Publications

  1. St-Louis J, Abad A, Funk S, Tilak M, Classey S, Zourikian N, McLaughlin P, Lobet S, Hernandez G, Akins S, Wells AJ, Manco-Johnson M, John J, Austin S, Chowdary P, Hermans C, Nugent D, Bakeer N, Mangles S, Hilliard P, Blanchette VS, Feldman BM. The Hemophilia Joint Health Score version 2.1 Validation in Adult Patients Study: A multicenter international study. Res Pract Thromb Haemost. 2022 Mar 25;6(2):e12690. doi: 10.1002/rth2.12690. 

  2. Feldman B; Funk S; Bergstrom BM; Zourikian N; Hilliard P; van der Net J; Engelbert R; Petrini P; van den Berg HM; Manco-Johnson MJ; Rivard GE.; Abad A and Blanchette V. Validation of a new pediatric joint scoring system from the International Hemophilia Prophylaxis Study Group: Validity of the Hemophilia Joint Health Score (HJHS).  Arthritis Care & Research . 2011 Feb; 63 (2):223-30.

  3. Wiedel J; Stabler S; Geraghty S and Funk S. Joint Replacement Surgery in Hemophilia. World Federation of Hemophilia Monograph Series 2010.

  4. Soucie JM.; Wang C; Forsyth A; Funk S; Denny M; Roach K;  Boone D. Range of Motion Measurements: Reference Values and a Database for Comparison Studies.  Haemophilia.. May 2011;17(3):500-507.

  5. 4. Feldman BM, Funk S, Lundin B, Doria AS, Ljung R and Blanchette V. Musculoskeletal measurement tools from the International Prophylaxis Study Group (IPSG).  Haemophilia 2008, 14 (Suppl.3), 162-169.

  6. Manco-Johnson MJ, Abshire TC, Shapiro AD, Riske B, Hacker MR, Kilcoyne R, Ingram JD,    Manco-Johnson  ML,  Funk SM,  Jacobson LJ, Valentino LA, Hoots WK, Buchanan GR, DiMichele D, Recht M, Brown D,  Leissinger C, Bleak S, Cohen A, Mathew P, Matsunaga A, Medeiros D, Nugent D, Thomas GA, Thompson AA,  McRedmond K, Soucie JM, Austin H, and Evatt BL.  Recombinant Factor VIII For the Prevention of Joint Disease in Children with Severe Hemophilia: Prophylaxis Compared With Episodic Treatment. NEJM 2007;357:535-44.

Current Positions/Chairs:

  • Co-Chair
    Musculoskeletal Health Expert Working Group- International Prophylaxis Study Group (IPSG)
  • Physiotherapist
    University of Colorado Hemophilia and Thrombosis Center

Key Institutions

  • • University of Colorado Anschutz Medical Campus
    Hemophilia and Thrombosis Center
    Colorado, USA
  • University of Colorado Anschutz Medical Campus
    Department of Pediatrics
    Colorado, USA

Research Activities

  • Physiotherapist for the follow-up study looking at long-term prophylaxis in children and a study looking at secondary prophylaxis in adults
  • Coordinator of joint physical examination for the Joint Outcomes Study (Manco-Johnson, NEJM, 2007)
  • HJHS Reliability (2003) and Validation Studies (2005-2007)

Research Interests

  • Identifying and quantifying early joint disease in hemophilia and the development of valid tools by which to track change and measure outcomes

Publications

October 15, 2020

Evaluating international Haemophilia Joint Health Score (HJHS) results combined with expert opinion: Options for a shorter HJHS.

Authors
Kuijlaars IAR, van der Net J, Feldman BM, Aspdahl M, Bladen M, de Boer W, CuestaBarriuso R, Matlary RED, Funk SM, Hilliard P, John JA, Kempton CL, de Kleijn P, MancoJohnson M, Petrini P, Poonnoose P, St-Louis J, Thomas S, Timmer MA, Trakymiene SS, van Vlimmeren L, Fischer K
Citation
Haemophilia. 2020 Oct 15. doi: 10.1111/hae.14180. Epub ahead of print. PMID: 33058441.
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August 11, 2020

Reference Ranges of HJHS Scores in Healthy Adult Males without Hemophilia

Authors
St-Louis J , Abad A , Akin S , Austin S , Chowdary P , Classey S , Funk S , Hernandez G , Hilliard P, Manco-Johnson M , S. Mangles S , McLaughlin P , Nugent D , Shapiro A, Srivastava A , Tilak M , Wells A , Zourikian N , Blanchette V , Feldman BM.
Citation
Research Practice in Thrombosis and Haemostasis 2020; 4 (S1): 521, PB1032.
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July 12, 2020

Reference Ranges of HJHS Scores in Healthy Adult Males without Hemophilia

The 2020 Virtual Congress of the International Society on Thrombosis and Haemostasis (July 12 - 14, 2020)
Authors
St-Louis J , Abad A , Akin S , Austin S , Chowdary P , Classey S , Funk S , Hernandez G , Hilliard P, Manco-Johnson M , S. Mangles S , McLaughlin P , Nugent D , Shapiro A, Srivastava A , Tilak M , Wells A , Zourikian N , Blanchette V , Feldman BM
Citation
May 20, 2018

Elevated HJHS scores in healthy adult males without hemophilia

The XXXI World Federation of Hemophilia Congress (May 20 -24, 2018 – Glasgow, Scotland)
Authors
St-Louis J, Zourikian N, Funk S, Tilak M, Lobet S, Manco-Johnson M, Srivastava A, Hilliard P, Tiseo L, Abad A, Wells A, Mangles S, Blanchette V and Feldman B.
Citation
May 10, 2018

Elevated HJHS Scores in healthy adult males without hemophilia

Authors
Feldman B, Zourikian N, Funk S, Tilak M, Lobet S, Manco-Johnson M, Srivastava A, Hilliard P, Tiseo L and St-Louis J
Citation
Haemophilia 2018; 24 (S5): 176, W- FPMED01- 002
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May 11, 2014

Global utilization of the International Prophylaxis Study Group (IPSG) physical therapy education web-site module

The XXX World Federation of Hemophillia Congress (May 11 -15, 2014 – Melbourne, Australia)
Authors
Hilliard P, Abad A, Feldman B M, Funk S, Manco-Johnson M, Petrini P, van der Net J, Zourikian N, and Blanchette VS on behalf of the International Prophylaxis Study Group
Citation
January 28, 2011

Validation of a new pediatric joint scoring system from the International Hemophilia Prophylaxis Study Group: Validity of the Hemophilia Joint Health Score (HJHS).

Authors
Feldman BM, Funk S, Bergstrom B-M, Zourikian N, Hilliard P, van der Net J, Engelbert RHH, Petrini P, van den Berg M , Manco-Johnson M, Rivard GE, Abad A, and Blanchette VS.
Citation
Arthritis Care & Research 2011 Feb; 63 (2):223-30.
View Publication
October 29, 2009

Use of the Hemophilia Joint Health Score

Physical Therapy Pre-Conference Symposium National Hemophilia Foundation 2009 Annual Meeting (October 29-31, 2009 - San Francisco, CA, USA).
Authors
Funk, S.
Citation
July 1, 2008

The Haemophilia Joint Health Score (HJHS) international validation study.

Authors
Feldman B M, Funk S, Hilliard P, van der Net J, Zourikian N, Bergstrom B-M, Engelbert RHH, Abad A, Petrini P, Manco-Johnson M, and on behalf of the International Prophylaxis Study Group.
Citation
Haemophilia 2008, 14 (S2), 83 # 12 PO 85.
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June 1, 2008

PT HJHS Pre-Congress Workshop

The XXVII International Congress of the World Federation of Hemophillia (June 1-5, 2008 – Istanbul, Turkey)
Authors
Hilliard, P, Funk S, Zourikian N, Bergstrom B-M, van der Net JJ, and Feldman BM
Citation
June 1, 2008

Musculoskeletal measurement tools from the International Prophylaxis Study Group (IPSG)

The XXVIII World Federation of Hemophilia Congress (June 1-5, 2008 – Istanbul, Turkey) Invited symposium as part of the scientific program of the WFH Congress (Chair: Dr. Victor Blanchette). Dr. Victor Blanchette, Overview of the International Prophylaxis Study Group, Ms. Sharon Funk and Dr. Brian Feldman, Hemophilia Joint Health Score. Dr. Andrea Doria and Dr. Bjorn Lundin, Role of MRI for detection of early arthropathy: A proposed new International MRI Score.
Authors
Feldman BM, Funk S, Lundin B, Doria AS, Blanchette V.
Citation
June 1, 2008

The Haemophilia Joint Health Score (HJHS) international validation study

The XXVIII World Federation of Hemophillia Congress (June 1-5, 2008 – Istanbul, Turkey).
Authors
Feldman B M, Funk S, Hilliard P, van der Net J, Zourikian N, Bergstrom B-M, Engelbert RHH, Abad A, Petrini P, Manco-Johnson M, and on behalf of the International Prophylaxis Study Group.
Citation
May 16, 2008

Musculoskeletal measurement tools from the International Prophylaxis Study Group (IPSG).

Authors
Feldman BM, Funk S, Lundin B, Doria AS, Ljung R, and Blanchette V.
Citation
Haemophilia 2008, 14 (Suppl. 3), 162-169.
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September 10, 2007

The economics of haemophilia prophylaxis: governmental and insurer perspectives. Proceedings of the Second International Prophylaxis Study Group (IPSG) Symposium.

Authors
Feldman BM, Aledort L, Bullinger M, Delaney FM, Doria AS, Funk S, Giangrande P, Lundin B, Manco-Johnson M, Miners A, Scriba PC, Srivastava A, Schramm W and Blanchette VS.
Citation
Haemophilia 2007 Nov; 13 (6): 745-749.
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August 15, 2006

Reliability study of the Hemophilia Joint Health Score.

Authors
Hilliard P, Funk S, Zourikian N, Bergstrom B-M, Bradley CS, McLimont M, Manco-Johnson M, Petrini P, van den Berg M, and Feldman BM.
Citation
Haemophilia 2004 Oct; 10 (S3): 79 # 16 S 03.
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August 15, 2006

Hemophilia joint health score reliability study.

Authors
Hilliard P, Funk S, Zourikian N, Bergstrom B-M, Bradley CS, McLimont M, Manco-Johnson M, Petrini P, van den Berg M, and Feldman BM.
Citation
Haemophilia 2006 Sept; 12: 518 – 525.
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June 10, 2006

Hemophilia Joint Health Score instructional video and manual.

Authors
Hilliard P, Abad A, Bradley CS, Funk S, Zourikian N, and Bergstrom B-M.
Citation
Haemophilia 2006 May; 12 (S2): # 18 FP 532
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May 21, 2006

Recent developments in clinimetric instruments

The XXVII World Federation of Hemophillia Congress (May 21-25, 2006 - Vancouver, Canada) Invited symposium as part of the scientific program of the WFH Congress (Chair: Karen Beeton). Funk S & Hilliard P – International Joint Health Score: Clinical Scoring System
Authors
Funk S, Hilliard P, Doria AS, Lundin B on behalf of the IPSG
Citation
May 21, 2006

Hemophilia Joint Health Score instructional video and manual

The XXVII World Federation of Hemophillia Congress (May 21-25, 2006 - Vancouver, Canada).
Authors
Hilliard P, Abad A, Bradley CS, Funk S, Zourikian N, and Bergstrom B-M.
Citation
October 17, 2004

Reliability study of the Hemophilia Joint Health Score

The XXVI World Federation of Hemophillia Congress (October 17-21, 2004 - Bangkok, Thailand).
Authors
Hilliard P, Funk S, Zourikian N, Bergstrom B-M, Bradley CS, McLimont M, Manco-Johnson M, Petrini P, van den Berg M, and Feldman BM.
Citation
October 8, 2004

Physical therapy and imaging outcome measures in a haemophilia population treated with factor prophylaxis: current status and future directions.

Authors
Manco-Johnson MJ, Pettersson H, Petrini P, Babyn PS, Bergstrom B-M, Bradley CS , Doria AS, Feldman BM, Funk S, Hilliard P, Kilcoyne R, Lundin B, Nuss R, Rivard G, Schoenmakers MA, van den berg M, Wiedel J, Zourikian N, and Blanchette VS.
Citation
Haemophilia 2004 Oct; 10 (S4):88 – 93.
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