Effects of myofascial release on frequency of joint bleedings, joint status, and joint pain in patients with hemophilic elbow arthropathy

Abstract

Background: Chronic joint injury of the elbow joint is common in patients with hemophilia. Myofascial release is used for the management of pain and functionality in patients with chronic restrictions. Objective: To evaluate the effectiveness of myofascial release in patients with hemophilic elbow arthropathy. Methods: Sixty-nine patients with hemophilia took part in this randomized controlled trial. They were recruited from 10 hemophilia patient Associations. They were randomly allocated to experimental (n = 35) or control group (n = 34). The intervention consisted of three 50-min sessions of fascial therapy over a 3-week period. The intervention included 11 bilaterally administered maneuvers in both upper limbs (from shoulder girdle to forearm). The study variables were frequency of elbow bleeding (self-report), joint status (Hemophilia Joint Health Score), and joint pain (visual analog scale) at baseline, after the intervention, and at the 3-month follow-up. Results: There were significant changes ( P < .001) in the repeated measures factor in the frequency of hemarthrosis ( F = 20.64), joint status ( F = 31.45), and perceived joint pain ( F = 30.08). We found group interaction with the ( P < .001) in the frequency of hemarthrosis ( F = 21.57), joint status ( F = 99.98), and perceived joint pain ( F = 44.26). There were changes ( P < .01) in the pairwise comparison analysis between the pretreatment assessment and the posttreatment and follow-up assessments. Conclusions: Myofascial release decreases frequency of elbow bleedings, and improved joint status and perception of elbow pain in patients with hemophilic elbow arthropathy. Myofascial release may be recommended to improve joint status and joint pain in patients with hemophilic elbow arthropathy.

Safety and efficacy of a self‐induced myofascial release protocol using a foam roller in patients with haemophilic knee arthropathy

“…Safety of this therapy has already been reported in previous articles where myofascial release techniques were applied to patients with haemophilic ankle 11,12 and elbow 13,14,32 arthropathy. This joint release process can decrease the mechanical joint factor which can favour a reduction in the frequency of hemarthrosis 33 …”

“…31 However, by applying prolonged interventions at up to 1-h intervals with low fibre elongation, permanent deformation can be achieved without inducing breakage or inflammation with mechanical stress using an applied force of 24-115 kg. 31 Safety of this therapy has already been reported in previous articles where myofascial release techniques were applied to patients with haemophilic ankle 11,12 and elbow 13,14,32 arthropathy. This joint release process can decrease the mechanical joint factor which can favour a reduction in the frequency of hemarthrosis.…”

“…10 A number of studies have reported the safety and efficacy of physiotherapy programs based on manual therapy using myofascial techniques in patients with haemophilic arthropathy of the ankle 11,12 and elbow. 13,14 Such studies noted a decrease in the frequency of hemarthrosis during the follow-up period, achieving improvements in range of motion and disability in patients with haemophilic arthropathy. Goto et al 15 described that monitoring the perception of pain combined with use of a prophylactic treatment are key aspects in order to reduce the frequency of bleeding and pain, thus improving joint function.…”

“…A number of studies have reported the safety and efficacy of physiotherapy programs based on manual therapy using myofascial techniques in patients with haemophilic arthropathy of the ankle 11,12 and elbow 13,14 . Such studies noted a decrease in the frequency of hemarthrosis during the follow‐up period, achieving improvements in range of motion and disability in patients with haemophilic arthropathy.…”

Hemophilic Arthropathy: Barriers to Early Diagnosis and Management

“…Similarly, physical exercise can promote a reduction in pain perception, improving range of motion and muscle strength in patients with hemophilia. 74,75 Other physiotherapy approaches, aimed at tackling tissue damage through myofascial therapy, 76,77 joint traction 78 and home exercises. 75 They have also shown their safety and efficacy in decreasing the frequency of hemarthrosis, improving range of motion and perceived joint pain.…”