Şiddetli Hemofili A Hastalarında Sınırlanmış Eklem Açıklığı ile İlişkili Atrofik Kaslarda Su İçi Egzersizlerin Etkisi: Bir Pilot Çalışma

Abstract

Purpose: Haemophilia causes musculoskeletal problems over many years secondary to recurrent hemarthrosis. In this study, the effects of water exercises on the musculoskeletal system of severe haemophilia A patients with muscle and joint problems were investigated. Material and Methods: Eleven severe haemophilia A patients on prophylaxis treatment participated in the study and following a regular exercise protocol. Results: Subjects displayed statistically significant increases in mid-thigh, upper thigh and calf circumference for right leg (42.0 ± 2.4, 43.0 ±2.1 ; 37.1 ±1.9, 39.0 ±1.8; 28.1 ± 1.4, 28.9 ±1.3 respectively) (mean ± SE) in mid-thigh and upper thigh for left leg (36.9 ± 1.5 , 38.9 ± 1.5 ; 41.2 ± 2.2 , 42.9 ± 2) (p<0.05). Compared to pre-exercise values, leg extensor and flexor strength as well as range of motion were increased significantly (96.6 ± 9º vs 104.5± 8º; before and after training for right knee, 98.5 ± 7.6 º vs 104 ± 7.9 º before and after training for left leg respectively) (p<0.05). In addition to that, post training serum level of growth hormone was found to be significantly higher than the pertaining value (p<0.05). Conclusion: These results show that some easily performed exercise protocols such as water exercises can promote muscle development and increase range of motion of the knee joint. Our findings indicate that appropriately designed water exercise may prevent muscle atrophy and joint deformities in haemopliliac patients. Key Words: Haemophilia, Water exercise, Muscle atrophy, Muscle strength. ÖZETAmaç: Hemofili tekrarlayan kanama ataklarına sekonder olarak kas-iskelet sorunlarına neden olmaktadır. Bu çalışmada, su içi egzersizlerinin, kas ve eklem problemleri olan şiddetli hemofili A hastalarında etkilerinin araştırılması amaçlanmıştır. Materyal ve Metod: Proflaksi alan, şiddetli hemofili A hastası (n=11) düzenli olarak egzersiz uygulamasına alınmıştır. Bulgular: Çalışmaya katılan hastaların, sağ bacaklarında üst bacak, orta bacak ve calf çevrelerinde (42.0 ± 2.4, 43.0 ±2.1 ; 37.1 ±1.9, 39.0 ±1.8; 28.1 ± 1.4, 28.9 ±1.3 respectively) (mean ± SE), sol bacaklarında üst ve orta bacak çevrelerinde (36.9 ± 1.5 , 38.9 ± 1.5 ; 41.2 ± 2.2 , 42.9 ± 2) egzersiz öncesi değerlerine göre istatistiksel olarak anlamlı