Effects of a supervised therapeutic exercise program on musculoskeletal health and gait in patients with haemophilia: A pilot study

Deniz, Volkan; Güzel, Nevin Atalay; Lobet, Sébastien; Antmen, Ali Bülent; Şaşmaz, Hatice; Kilci, Abdullah; Boyraz, Omer Cumhur; Günaşti, Özgür; Kurdak, S. S.

doi:10.1111/hae.14444

Cited by 3 publications

(11 citation statements)

References 29 publications

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“…Among the studies included, ten studies performed the 6MWT in a corridor of at least 20 m or reported compliance with American Thoracic Society guidelines and were included in the secondary analysis 22,26,27,29,30,33–37 . Four studies were excluded from the secondary analysis, two for using a corridor of less than 20 m (i.e., 8 and 15 m) 12,32 and two studies for not reporting corridor length or not adhering to technical guidelines 28,31 .…”

Section: Resultsmentioning

confidence: 99%

“…Fourteen studies assessed physical capacity using the 6MWT 12,22,26–37 . In children, the distance walked ranged from 274 ± 36 30 to 680 ± 100 m 26 .…”

Section: Resultsmentioning

confidence: 99%

“…To assess exercise capacity, 14 studies used the distance walked (metres) on the 6MWT. 12,22,[26][27][28][29][30][31][32][33][34][35][36][37] On the other hand, six studies used the CPET method: one of them performed CPET on a treadmill, 23 four on a bicycle ergometer, [20][21][22]25 and one study used Cooper's oxygen uptake tests. 24 The results of the studies for exercise capacity are shown in Table 2.…”

Section: Type Of Assessmentmentioning

confidence: 99%

“…Fourteen studies were conducted in Europe, three in Asia, one in South America and one in Africa. Regarding the design, eleven were cross-sectional, 12,[20][21][22][23][25][26][27][28]32,34 five were RCTs, 29,30,33,35,36 two were prospective, 31,37 and one was a before-after study. 24 In total, 825 PWH (530 children, 117 adolescents and 178 adults)…”

Section: Study Characteristicsmentioning

confidence: 99%

“…21,25 In the prospective studies (n = 3), the percentage of quality compliance ranged from 56% 31 to 82%. 37 In the total number of articles included, seven studies had a 'low risk of bias' , 21,22,25,26,30,34,37 eight had a 'moderate risk of bias' , 20,24,27,29,31,33,35,36 and four had a 'high risk of bias' . 12,23,28,32 The results of the quality assessment of individual studies obtained using the JBI Critical Appraisal Toolsare presented in Supplementary File (Table S1, S2 and S3).…”

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

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Exercise capacity in people with haemophilia: A systematic review

et al. 2022

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Introduction Exercise capacity has been established as a protective factor against joint impairment in people with haemophilia (PWH). However, little is known about how exercise capacity is affected in PWH. Aim To analyse exercise capacity, as assessed by standardised laboratory or field tests in PWH. Methods A systematic review was conducted to identify manuscripts investigating physical capacity in PWH. An electronic search of PubMed/MEDLINE, Embase, Web of Science, CENTRAL and CINAHL was conducted from inception to 13 April, 2022. Two independent reviewers performed data extraction and assessed study quality using the critical appraisal tools of the Joanna Briggs Institute. Results Nineteen studies with 825 patients were included. Most studies used the six‐min walk test (6MWT) or peak/maximal oxygen consumption (VO2max). In children, the distance walked ranged from 274 ± 36.02 to 680 ± 100 m. In adults, the distance walked ranged from 457.5 ± 96.9 to 650.9 ± 180.3 m. VO2max ranged from 37 ± 8 to 47.42 ± 8.29 ml kg–1 min–1. Most studies reported lower values of exercise capacity compared to standardised values. Overall, the quality of the studies was moderate. Conclusion Most of the studies showed that PWH have lower exercise capacity compared to reference values of 6MWT or VO2max. Based on these results, it is necessary to emphasise in both the promotion and the prescription of physical exercise in PWH.

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Section: Resultsmentioning

confidence: 99%

“…Fourteen studies assessed physical capacity using the 6MWT 12,22,26–37 . In children, the distance walked ranged from 274 ± 36 30 to 680 ± 100 m 26 .…”

Section: Resultsmentioning

confidence: 99%

Section: Type Of Assessmentmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

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Exercise capacity in people with haemophilia: A systematic review

et al. 2022

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A clinical practice guideline for primary care physiotherapy in patients with haemophilia

Blokzijl,

Pisters,

Aspdahl

et al. 2024

Haemophilia

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IntroductionAs a result of centralisation of haemophilia care to a limited number of intramural settings, many persons with haemophilia have to travel long distances to attend their haemophilia specialised treatment centre. However, regular physiotherapy treatment can be provided by primary care physiotherapists in the personʼs own region. Due to the rarity of the disease most primary care physiotherapists have limited experience with this population. This study aims to provide a clinical practice guideline for primary care physiotherapists working with persons with bleeding disorders.MethodA list of the most urgent key‐questions was derived from a previous study. Literature was summarised using the grading of recommendations assessment, development, and evaluation (GRADE) evidence‐to‐decision framework. Recommendations were drafted based on four 90 min consensus meetings with expert physiotherapists. Recommendations were finalised after feedback and >80% consensus of all stakeholders (including PWH, physiotherapists, haematologists and the corresponding societies).ResultsA list of 82 recommendations was formulated to support primary care physiotherapists when treating a person with a bleeding disorder. These recommendations could be divided into 13 categories: two including recommendations on organisation of care, six on therapy for adult patients with bleeding disorders and five on therapy adaptations for paediatric care. Therapy recommendations included treatment after a joint‐ or muscle bleed, haemophilic arthropathy, chronic synovitis, non‐haemophilia related conditions and orthopaedic surgery.ConclusionAn evidence‐based practice guideline, based on current evidence from literature and clinical expertise, has been developed for primary care physiotherapists treating a person with haemophilia. To improve care, the recommendations should be implemented in daily practice.

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Comparison of Efficiency of Closed Kinetic Chain Exercises versus Proprioceptive Exercises in Improving Balance and Gait in Hemophilia: Protocol for a Randomized Controlled Trial (Preprint)

Poyraz İşleyen,

Tarakcı,

Leblebici

et al. 2024

Preprint

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BACKGROUND Inherited bleeding disorders are characterized by prolonged bleeding due to protein deficiencies involved in blood clotting, with hemophilia A and hemophilia B being the most common types. The severity of bleeding in people with hemophilia (PwH) varies on the level of deficient factor and treatment includes coagulation factor concentrates, nonreplacement preparations, gene therapies and physiotherapy methods. Thus, bleeding is prevented, symptoms are reduced and quality of life is improved. OBJECTIVE The aim is to investigate the effects of closed kinetic chain exercises and proprioceptive exercise training on improving balance and walking in PwH. METHODS This study is planned a 3-arm, parallel-group randomized controlled trial. The study will include 63 PWH aged between 13 and 25 years who attend meet the inclusion criteria. The primary outcome measures are medio-lateral swing, anterior-posterior swing, walking speed and hemophilia joint health score. Secondary outcome measures are kinematic assessment of gait, one-leg stand test, 6-Minute Walk Distance (6 MWD) test, proprioception assessment and Hemophilia Functional Independence Score. Participants will be evaluated with Biodex Balance System for postural sway, 10-meters walking test for gait speed, Hemophilia Joint Health Score for joint health, Kinovea 2D motion analysis for kinematic evaluation of gait, one leg stand test for balance measurement, 6 MWD for functional capacity, digital goniometer for proprioception, Functional Independence Score in Hemophilia for functional independence. Participants will be randomly assigned to a closed kinetic chain group, a proprioceptive group, or a controlled group. Following randomization, all participants in exercise training groups will receive a 30-minute education session on joint protection techniques and energy conservation prior to the first exercise session. Closed kinetic chain exercises will include progressive lower limb exercises duration of approximately 45 minutes each session. Proprioceptive exercise training will focus on vibration training, reposition exercises and proprioception exercises will be given to increase proprioceptive input on same duration as the other group. The control group will receive no interventions. All participants will undergo 24 exercise sessions (2 days a week for 12 weeks). After the treatment, the initial measurements will be repeated. RESULTS The study have began in September 2023 and scheduled to be completed in January 2025. CONCLUSIONS The study will investigate the effects of two different exercise on functional parameters in PWH. The effects of different exercise protocols on parameters such as postural sway, walking speed, joint health will be evaluated. It is predicted that both exercise methods may have positive effects on balance and gait. CLINICALTRIAL Clinical Trials.gov NCT05879549

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Effects of a supervised therapeutic exercise program on musculoskeletal health and gait in patients with haemophilia: A pilot study

Cited by 3 publications

References 29 publications

Exercise capacity in people with haemophilia: A systematic review

Exercise capacity in people with haemophilia: A systematic review

A clinical practice guideline for primary care physiotherapy in patients with haemophilia

Comparison of Efficiency of Closed Kinetic Chain Exercises versus Proprioceptive Exercises in Improving Balance and Gait in Hemophilia: Protocol for a Randomized Controlled Trial (Preprint)

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