Fascial Therapy in Elbow Hemophilic Arthropathy

Real Fundación Victoria Eugenia69 enrolled

Overview

Introduction: The common clinical manifestations of hemophilia are skeletal muscle bleeds, especially hematomas and hemarthrosis. Repeated episodes of joint bleeding in certain joints, causing a progressive joint deterioration. Secondary disorders to this joint degeneration include: biomechanical alterations, loss of range of movement and periarticular muscle atrophy. Design. A prospective, multicenter and longitudinal pilot study to evaluate the efficacy of a treatment protocol with fascial therapy applied in patients with hemophilic arthropathy of the elbow. Aimed: To evaluate the safety and efficacy of a physiotherapy treatment by fascial therapy in patients with hemophilic arthropathy of the elbow Patients: A total of 60 patients with hemophilia and prophylactic treatment will be recruited for inclusion in the study. Patients will be recruited in 6 centers, from different regions of Spain. Intervention: Each session will last approximately 50 minutes, with three physiotherapy sessions taking place over a period of 3 weeks. The treatment program includes 11 maneuvers that must be administered bilaterally: Measuring instruments and study variables: goniometric evaluation (range of movement); visual analog scale (joint pain); Haemophilia Joint Health Score (joint status); DASH Questionnaire (functionality of upper limbs); SF-36 Questionnaire (perception of quality of life). At the same time, the study will allow to determine joint bleeding caused by applied physiotherapy treatment. Expected results: First, it is intended to demonstrate the safety of this physiotherapy technique in patients with hemophilia. Likewise, an improvement in the perception of elbow pain and joint mobility is expected. An improved functionality of the upper limb is also foreseen and with it, an enhanced perception of quality of life of these patients.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Interventions

Experimental groupOTHER

Longitudinal surface sliding maneuver over the superficial fascia in the anterior region of the arm and the forearm. Applied in 3 strokes. * Transverse sliding of the flexor muscles of the wrist and fingers. * Transverse sliding for the biceps brachii muscle. * Longitudinal surface sliding over the superficial fascia in the posterior arm region. * Transverse sliding over the brachial triceps tendon. * Transverse sliding for the pectoralis major muscle. * Transverse sliding for the posterior axillary region pectoralis major muscle. * Induction of the posterior axillary fold. * Induction (crossed hands over the brachial region and forearm). * Maneuver of transverse planes for the cervicothoracic region. * Upper limb telescopic maneuver.

Eligibility

Sex: MALEMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients diagnosed with hemophilia A and B * Patients adults (over 18 years) * Patients diagnosed with hemophilic arthropathy of the elbow (by clinical assessment with the Hemophilia Joint Health Score) * Patients pn prophylactic treatment with FVIII / FIX concentrates. Exclusion Criteria: * Patients without ambulation ability * Patients with inhibitors * Patients with neurological or cognitive alterations that impede the comprehension of the questionnaires and physical tests * Patients who have not signed the informed consent document.

Outcomes

Primary Outcomes

Change from baseline elbow joint bleeding frequency after treatment and at 3 months

After the first session of physiotherapy patients will be given a self-register where they can record all the observations they feel (from hematomas or hemarthros, to any other discomfort or perception). Similarly, the principal investigator of the study will monitor all patients within 48 hours after each physical therapy session.