Low Frequency Physiotherapy on Joint Health, Hemarthrosis, Walking, Balance and Reaction Time in Hemophilic Arthropathy: a Controlled Trial

Abstract

BackgroundPhysiotherapy is recommended for people with hemophilic arthropathy (PwHA) to improve musculoskeletal health and is typically administered in 2 or 3 sessions per week. We aimed to investigate the effects of once a week comprehensive physiotherapy and home exercise on musculoskeletal system of PwHA.MethodsIn this study 19 young PwHA with knee and/or ankle were non-randomly divided into two groups: The Home Exercise Group (HEG) and the Comprehensive Physiotherapy Group (CPG). Joint health was evaluated with the Hemophilia Joint Health Score (HJHS), muscle strength (MS) with manual muscle tester, range of motion (ROM) with universal goniometer, pain with Numerical Pain Scale (NPS). The following functional tests were used: 6 min Walking Test (6MWT) for walking capacity, Functional Reach Test (FRT) for dynamic balance and Fitlight (R) system for visuomotor reaction time (VMRT). The frequency of hemarthrosis (FoH) in the last 6 weeks was obtained from the self-recorded data. The CPG received comprehensive physiotherapy once a week, including manual therapy, neuromuscular electrical stimulation and supervised exercises, and they performed home exercises for the other two days of the week. The HEG only performed home exercises 3 days a week. All the treatments lasted 6 weeks and evaluations were repeated.ResultsCompared with the HEG, the CPG significantly ameliorated for NPS, FoH, HJHS, VMRT (time and mean), 6MWT, all MS and several ROMs. CPG significantly improved in all outcomes except for 1 ROM. The HEG significantly improved in FoH, HJHS, VMRT (time), 6MWT and MS, but not in the ROMs.ConclusionComprehensive physiotherapy once a week and continuing home exercise significantly improve joint health, functionality and balance, and reduce pain and hemarthrosis in PwHA.Trial registrationThe study was registered at Clinicaltrials.gov (Study ID NCT06331091, retrospectively registered).