Safety and effectiveness of fascial therapy in adult patients with hemophilic arthropathy. A pilot study

Physiother Theory Pract. 2018 Oct;34(10):757-764. doi: 10.1080/09593985.2018.1425513. Epub 2018 Jan 15.

Abstract

Background: The primary clinical manifestations of hemophilia are muscle and joint bleeding. Recurrent bleeding leads to a degenerative process known as hemophilic arthropathy. Fascial therapy is one of the most used physiotherapy techniques today to improve joint dysfunctions and chronic pain.

Objective: To assess the safety and efficacy of fascial therapy treatment in patients with hemophilic arthropathy of ankle and knee.

Design: Non-randomized, controlled clinical trial.

Intervention: Sixteen patients with hemophilia were allocated to an experimental group or to a control group. The physiotherapy intervention was performed through three sessions (one per week), for 60 min per session. Patients received a physiotherapy treatment using a fascial therapy protocol for patients with hemophilia.

Main outcome measures: The joint status was evaluated using the Hemophilia Joint Health Score; pain was assessed with the Visual Analogue Scale; the range of movement was evaluated using a universal goniometer; the flexibility of the hamstring muscles was assessed with the fingertip-to-floor, and the lumbar mobility through the Schöber test.

Results: We observed significant differences in the experimental group for both quality of life and illness behavior. There was no significant improvement in the joint status; however, an improvement was noted in terms of perception of pain in the ankle.

Conclusions: A physiotherapy program based on fascial therapy is safe in patients with hemophilia. Fascial therapy may improve joint status, pain, and mobility in patients with hemophiliac arthropathy of the knee and ankle.

Keywords: Chronic pain; fascial therapy; hemophilic arthropathy; patient safety; range of movement.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Ankle Joint / physiopathology*
  • Arthrometry, Articular
  • Back Muscles*
  • Biomechanical Phenomena
  • Hamstring Muscles / physiopathology
  • Hemarthrosis / diagnosis
  • Hemarthrosis / etiology
  • Hemarthrosis / physiopathology
  • Hemarthrosis / therapy*
  • Hemophilia A / complications*
  • Hemophilia A / diagnosis
  • Humans
  • Illness Behavior
  • Knee Joint / physiopathology*
  • Male
  • Middle Aged
  • Pain Measurement
  • Pilot Projects
  • Quality of Life
  • Range of Motion, Articular
  • Spain
  • Therapy, Soft Tissue / methods*
  • Time Factors
  • Treatment Outcome