Objectives: To assess the efficacy of performing a therapeutic exercise program, compared with usual care, on pain relief, range of movement and self-perceived quality of life in patients with hemophilia Design: Quantitative, experimental, longitudinal and prospective study. Subjects: Male patients between 30 and 45 years old, with hemophilia type A or B and with knee, ankle or elbow arthropathy caused by hemophilia. Participants may be undergoing a pharmacologic treatment with intravenous VIII and/or IX factor Methods: Participants in the experimental group will an intervention based on therapeutic exercise. One therapist will instruct the patients during two sessions (each lasting approximately 1 hour). Participants will be asked to continue this program at least twice a week. Meanwhile, those in the control group will receive usual physical therapy care, based on a more passive approach, including self-assisted joint mobilization and muscle stretching. Those in the control group will be also instructed to perform the protocol at home, at least twice a week. The intervention protocol in both groups will last three months
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
5
Patients will perform an exercise protocol specifically designed for patients with hemophilia that will include exercises focused on improving range of movement, strength, flexibility, balance and coordination as well as diaphragmatic breathing at the start and at the beginning of each session.
Patients will undergo usual physical therapy treatment for hemophiliacs, based on affected self and gentle joint mobilization and stretching of muscles involved in the affected joints.
University of Sevilla
Seville, Spain
Pressure pain threshold (PPT) in the evaluated muscles.
The PPT levels will be evaluated in KPa. PPT levels, defined as the minimum necessary pressure to evoke pain will be evaluated using a handheld electronic pressure algometer.
Time frame: Change from baseline to 3 months after intervention
Self-reported pain intensity: Numeric Pain Rating Scale (NPRS)
Self-reported pain will be evaluated using the Numeric Pain Rating Scale (NPRS), where 0 denotes no pain at all, and 10 denotes the maximum possible pain.
Time frame: Change from baseline to 3 months after intervention
Range of movement (ROM).
Active ROM of the affected joint will be evaluated using inertial sensors, that measure lineal acceleration and angular velocity.
Time frame: Change from baseline to 3 months after intervention
General flexibility
General flexibility will be assessed using the improved tot-flex test, which makes possible to extrapolate general flexibility from a combined movement measure.
Time frame: Change from baseline to 3 months after intervention
Daily life activities
Ordinary daily life activities will be assessed using the Haemophilia Activities List, which measures the self-perceived functional state.
Time frame: Change from baseline to 3 months after intervention
Self-perceived quality of life: A36 Haemophilia-QoL test
Quality of life will be evaluated using the A36 Haemophilia-QoL test. This is a valid and specific tool for hemophiliac adults.
Time frame: Change from baseline to 3 months after intervention
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.