The effects of manual therapy on musculoskeletal system, functional level, joint health and kinesiophobia in young adults with severe haemophilia: A randomized pilot study

Abstract

Introduction The effects of manual therapy (MT) on joint health and functional level in haemophilic arthropathy (HA) have relatively under‐explored. Aim To investigate the effects of MT in HA of lower limb joints on musculoskeletal system, functional level, Functional Independence Score in Hemophilia (FISH), Hemophilia Joint Health Score (HJHS) and kinesiophobia. Methods Seventeen patients were randomized to the control group (CG = 9) and manual therapy group (MTG = 8). The number of haemarthrosis (NoH) was recorded from the diaries. Range of motion (ROM), strength and pain intensity were measured using goniometer, digital dynamometer and visual analogue scale, respectively. Joint health was evaluated with HJHS, functional independence with FISH, and kinesiophobia with Tampa Scale. Functional Reach (FR), Timed Up‐Go (TUG) and 5‐Times Sit‐to‐Stand (5*STS) tests were used to evaluate functional level. Home exercises were given to both groups. Additionally, myofascial release techniques and mobilizations were applied to MTG. Interventions were applied 3 d/weekly for 5 weeks. Assessments were performed at baseline and after treatment. Results ROM, strength, activity pain, HJHS and FISH were improved in MTG (p˂0.05). Ankle NoH, 5*STS and FR were developed in both groups (p˂0.05), but kinesiophobia, TUG and knee NoH were not significant. Although improvements were observed in favour of MTG in HJHS, FR, activity pain and ankle strength/ROM (p˂0.05), no significant difference was found in FISH, kinesiophobia, TUG, 5*STS, resting pain and knee strength. Conclusion Reduction in ankle NoH indicated that both interventions were safe. The use of MT in HA of lower limb joints was an effective physiotherapy approach to improve functional level, joint health and functional independence.

The effects of close kinetic chain exercises on proprioception and physical activity level in pediatric patients with hemophilia

“…In that study, one group received a home-based programme consisting of strengthening and stretching exercises, while the other group received manual therapy additionally. Comparable improvements were demonstrated with FISH scores in both groups 39. In our study, post-treatment FISH scores showed improvement ver-sus baseline in both SG and CTG.…”

The evolution of physiotherapy in the multidisciplinary management of persons with haemophilia (PWH): A scoping review

“…Fifty‐two articles 1,15,17–66 dealt with rehabilitation and preventive physiotherapy. Most of them aimed to map the options for the management of PWH or demonstrate the role of physiotherapy, not only in the presence of clinical problems but also for preventive purposes and to allow a healthy growth.…”

180‐degree immersive VR motion visualization in the treatment of haemophilic ankle arthropathy

“…The patient was placed in a supine position and with his knees slightly flexed, and his foot off the stretcher. The axis of the goniometer was placed on the lateral side of the lateral malleolus, the fixed arm aligned with the fibula and the mobile arm parallel to the fifth metatarsal 31 . Goniometric assessment of ankle range of motion has shown high interobserver reliability (ICC: .85–.96) 33 .…”

“…Muscle strength was measured with a pressure dynamometer (Lafayette Manual Muscle Tester 01165) 30 . The patient was placed in a supine position with his foot at 90° dorsal flexion 31,32 . The patient was asked to conduct two 5‐s maximum isometric contractions, with a 30‐s break in between, against the dynamometer held by the evaluator 31,32 .…”

“… 30 The patient was placed in a supine position with his foot at 90° dorsal flexion. 31 , 32 The patient was asked to conduct two 5‐s maximum isometric contractions, with a 30‐s break in between, against the dynamometer held by the evaluator. 31 , 32 For the evaluation of the gastrocnemius strength, the dynamometer was placed proximal to the metatarsophalangeal joints on the plantar side.…”