Haemophilia
Conditions
Keywords
Hemophilia, Educational Physiotherapy, Pain, Quality of life, Illness Behaviour, Elbow
Brief summary
Although arthropathy is a serious problem in patients with hemophilia due to the associated morbidity and incapacity, to the best of the investigators knowledge, no studies have looked at the effect of educational physiotherapy for its clinical improvement. This contribution presents the results of educational physiotherapy program applied for 15 weeks with home exercises - in patients with hemophilic arthropathy. After treatment, experimental group showed improved a significant reduction of pain, and best quality of life al illness behaviour. During treatment no patient showed elbow haemarthrosis, which underlines the safety of this physiotherapy program.
Interventions
OTHEREducational physiotherapy group
20 patients with hemophilia were randomly allocated to an educational intervention or to a control group. The educational intervention was performed every two weeks during 15-week and home exercises were performed once a day, 6 days a week, in the same time
Sponsors
Real Fundación Victoria Eugenia
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
MALE
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Patients diagnosed with hemophilia A or B * Patients over 18 years * Patients with hemophilic arthropathy with at least 1 involved joint (elbow, knee or ankle) * having signed the informed consent document.
Exclusion criteria
* Patients diagnosed with other congenital bleeding disorders (i.e. von Willebrand disease) * Patients who developed antibodies to FVIII or FIX (inhibitors) * Those not able to ambulate as a result of hemophilic arthropathy or any other disability
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change from baseline frequency of bleedings after treatment and at 6 months | Screening visit, within the first seven days after treatment and after six months follow-up visit | The frequency of bleeding is measured with a record which complete the patients, where they indicate the incidence of hematomas and hemarthrosis during the treatment and follow-up. |
| Change from baseline physical condition of joints after treatment and at 6 months | Screening visit, within the first seven days after treatment and after six months follow-up visit | The physical condition of joints was assessed using the Gilbert scale that measures swelling, muscle atrophy, joint crepitus, range of motion, axial deformity and instability. Scores range from 0 to 12 (0 represents no joint injury and 12 represents maximum joint deterioration). |
| Change from baseline joint pain after treatment and at 6 months | Screening visit, within the first seven days after treatment and after six months follow-up visit | Joint pain was assessed using the Visual Analog Scale (VAS), with scores ranging from 0 (no pain at all) to 10 (the worst pain imaginable by the patient). |
| Change from baseline perception of the quality of life after treatment and at 6 months | Screening visit, within the first seven days after treatment and after six months follow-up visit | The Haemophilia A-36 questionnaire was used to assess the perception of the quality of life. This questionnaire consists of 36 items that assess 9 domains (physical health, daily activities, joint damage and pain, treatment satisfaction, treatment difficulties, emotional functioning, mental health and social relationships). |
| Change from baseline illness behavior after treatment and at 6 months | Screening visit, within the first seven days after treatment and after six months follow-up visit | To assess illness behavior, patients completed the Illness Behavior Questionnaire (IBQ). This scale consists of 62 items and 8 domains (hypochondriasis, disease conviction, psychological vs. somatic perception of illness, affective inhibition, affective disturbance, denial and irritability). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Age | Screening visit | Age of patients included in the study |
| Weight | Screening visit | Weight of the patients |
| Height | Screening visit | Height of patients |
| Radiological joint deterioration | Screening visit | All patients had an assessment of radiological joint deterioration using the Pettersson scale. This scale, with scores ranging from 0 (a normal joint) to 13 (maximum joint deterioration), is the most widely used to assess joint degeneration produced by hemophilic arthropathy. The evaluation of radiological joint damage was done at the beginning of the study. |
Outcome results
None listed