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Manual and educational therapy in the treatment of hemophilic arthropathy of the elbow: a randomized pilot study.

ABSTRACT: BACKGROUND:Elbow arthropathy is characteristic in patients with hemophilia. Arthropathy is manifested by decreased range of motion, pain, loss of strength and muscular atrophy, and axial changes. The objective is to evaluate the safety of two physiotherapy programs combining manual therapy and home exercises with educational sessions in patients with hemophilic elbow arthropathy. METHODS:This is a randomized study with 27 patients with elbow hemophilic arthropathy with a mean age of 34.48 (SD: 12.99) years, were randomised to Manual Therapy group, educational group and control group. The physiotherapy programmes were: manual therapy through joint traction, passive muscles stretching and proprioceptive neuromuscular facilitation; and educational sessions and daily home exercises. The study lasted for twelve weeks, with two sessions a week in manual therapy group and one session every two weeks with daily home exercises in educational group. The variables measured were range of motion of elbow, biceps strength, circumference of arm, and elbow pain. RESULTS:The treatment with manual therapy improved the circumference of arm, flexion elbow and elbow pain. Six months later, MT group still enjoyed improved. In the educational group there were improvements, but not significant, in the measured variables. CONCLUSION:Neither of the two physiotherapy interventions caused elbow hemarthrosis. The treatment with manual therapy improved the range of movement and circumference of arm, and lessened pain in hemophilic patients with chronic elbow arthropathy. No hemarthrosis was recorded during treatment or during the follow-up period. Larger randomized clinical trials are required to confirm the results of this study. TRIAL REGISTRATION:( NCT02198040 ). Registered 22 July 2014, retrospectively registered.

SUBMITTER: Cuesta-Barriuso R

PROVIDER: S-EPMC6122620 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Manual and educational therapy in the treatment of hemophilic arthropathy of the elbow: a randomized pilot study.

Cuesta-Barriuso Rubén R Gómez-Conesa Antonia A López-Pina José-Antonio JA

Orphanet journal of rare diseases 20180903 1

<h4>Background</h4>Elbow arthropathy is characteristic in patients with hemophilia. Arthropathy is manifested by decreased range of motion, pain, loss of strength and muscular atrophy, and axial changes. The objective is to evaluate the safety of two physiotherapy programs combining manual therapy and home exercises with educational sessions in patients with hemophilic elbow arthropathy.<h4>Methods</h4>This is a randomized study with 27 patients with elbow hemophilic arthropathy with a mean age ...[more]

PMID: 30176883

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Project description:BackgroundHemophilic ankle arthropathy is manifested by degenerative functional alterations and chronic pain. Myofascial release techniques are used to treat soft tissue adhesions, relieve pain, and reduce tissue sensitivity.ObjectiveThis study aims to evaluate the safety and efficacy of a protocol using self-myofascial release with a foam roller to be applied in patients with hemophilic ankle arthropathy.MethodsPatients with ankle arthropathy (N=70) will be recruited, enrolled, and assigned to one of two groups-experimental or control-in a 1:1 allocation ratio. Patients will be recruited from 5 centers in different regions of Spain. Patient data will be collected at baseline, posttreatment, and follow-up. The primary outcome will be frequency of ankle joint bleeding (self-reported). The secondary outcomes will be ankle range of motion (measured with a digital goniometer); joint pain (measured with a visual analog scale and an algometer); joint status (measured using the Hemophilia Joint Health Score); muscle strength (measured with a dynamometer); functionality of lower limbs (measured using the 6-minute walking test); activity (self-reported); and muscle flexibility (measured using the fingertip-to-floor test). The treatment program includes 11 exercises that must be administered bilaterally. A mobile app will be developed where each patient will be able to observe the exercises to be carried out. Each session will last 15 minutes with 5 physiotherapy sessions per week for a period of 3 months. It is expected that patients with hemophilia who receive the foam roller intervention will show improvement in mobility, pain, and status of the ankle joint; muscle strength; and function in the lower extremities.ResultsThe study has been approved by the institutional review board of the University of Murcia. Patient recruitment will begin in September 2020, and the intervention period will last until June 2021. Data collection will take place between September 2020 and October 2021.ConclusionsThis protocol describes a randomized clinical trial to examine the safety and efficacy of a self-myofascial release intervention using a foam roller in patients with hemophilic ankle arthropathy.Trial registrationClinicalTrials.gov NCT03914287; http://clinicaltrials.gov/ct2/show/NCT03914287.International registered report identifier (irrid)PRR1-10.2196/15612.

Dataset Information

Manual and educational therapy in the treatment of hemophilic arthropathy of the elbow: a randomized pilot study.

Publications

Manual and educational therapy in the treatment of hemophilic arthropathy of the elbow: a randomized pilot study.

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