The aim of this study is to investigate the effect of individualized physical therapy, combined manual therapy and exercise intervention, for pain perception, range of motion (ROM), muscle strength, joint health, cardiopulmonary endurance and quality of life (QoL) in patients with severe hemophilia A and multiple hemophilic arthropathy.
The main clinical manifestations of hemophilia are muscle and joint bleeding. Recurrent bleeding leads to a degenerative process known as hemophilic arthropathy. Past studies investigated the effect of manual therapy of exercise for individuals with hemophilia and found to enhance muscle strength, balance, fitness and promote quality of life. However, less study has evaluated the safety and effectiveness of manual therapy combined with exercise for individuals with multiple hemophilic arthropathy. Therefore, the aim of this study is to investigate the effect of individualized physical therapy, combined manual therapy and exercise intervention, for pain perception, range of motion (ROM), muscle strength, joint health, cardiopulmonary endurance and quality of life (QoL) in patients with severe hemophilia A and multiple hemophilic arthropathy.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
10
1. Manual therapy included fascia release, progressive passive stretch, mobilization, etc.(depend on subject's current condition) 2. Exercise included muscle strengthening, trunk (spine) stabilization exercise. (depend on subject's current condition)
Far Eastern Memorial hospital
New Taipei City, Taiwan
RECRUITINGHemophilia Joint Health Score (HJHS)
To measure joint health, in the domain of body structure and function (i.e. impairment), of the joints most commonly affected by bleeding in hemophilia: the knees, ankles, and elbows. It provides a total score (higher score is worse; max=124), joint specific scores, and a global gait score.
Time frame: before intervention (baseline), after intervention 6th week and 12th week
Visual Analogue Scale (VAS)
To assess the target joint pain in hemophilia. The minimum value is 0, and the maximum value is 10 (higher score is worse).
Time frame: before intervention (baseline), after intervention 6th week and 12th week
6 minute walk test
To evaluate cardiopulmonary endurance. The predictive equation for males: 6MWD(m) = 867 - (5.71 age, yrs) + (1.03 height, cm). The predictive equation for females: 6MWD(m) = 525 - (2.86 age, yrs) + (2.71 height, cm) - (6.22BMI).
Time frame: before intervention (baseline), after intervention 6th week and 12th week
Hemophilia Activity List (HAL)
To measure the impact of hemophilia on self-perceived functional abilities in adults.Normalized scores for the domains, components, and the full questionnaire can also be obtained. Missing values are controlled for and the possible scores range from 0 to 100, where 0 represents the worst possible functional status and 100 the best possible functional status.
Time frame: before intervention (baseline), after intervention 6th week and 12th week
EQ-5D-5L
To measure the quality of life. Each dimension now has five response levels: no problems (1), slight problems (2), moderate problems (3), severe problems (4), unable to/extreme problems (5). The minimum value is 55555 and the maximum value is 11111 (higher score is worse). EQ VAS：the minimum score is 0, and the maximum score is 100 (higher score is better).
Time frame: before intervention (baseline), after intervention 6th week and 12th week
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Daily notes
record each intervention, such as manual therapy and exercise
Time frame: once a week (each intervention) for 3 months