Severe Hemophilia
Conditions
Keywords
Physiotherapy, Manual therapy, Exercise
Brief summary
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.
Detailed description
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.
Interventions
OTHERManual therapy combined exercise
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)
Sponsors
Far Eastern Memorial Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
20 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* over 20 years old and diagnosed with severe hemophilia * those who receive prophylaxis regularly * there are more than 2 target joints (hemophilic arthropathy)
Exclusion criteria
* unwilling to sign the informed consent * any neurological disease or specific musculoskeletal condition (such as fracture) one year ago * more than 3 (excluding 3) joint replacement surgeries (different joints) * unable to walk due to hemophilia joint disease or any other diseases * major bleeding events that pose risks or hinder research * unable to follow instructions due to cognitive impairment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Hemophilia Joint Health Score (HJHS) | before intervention (baseline), after intervention 6th week and 12th week | 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. |
| Visual Analogue Scale (VAS) | before intervention (baseline), after intervention 6th week and 12th week | To assess the target joint pain in hemophilia. The minimum value is 0, and the maximum value is 10 (higher score is worse). |
| 6 minute walk test | before intervention (baseline), after intervention 6th week and 12th week | 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). |
| Hemophilia Activity List (HAL) | before intervention (baseline), after intervention 6th week and 12th week | 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. |
| EQ-5D-5L | before intervention (baseline), after intervention 6th week and 12th week | 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). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Daily notes | once a week (each intervention) for 3 months | record each intervention, such as manual therapy and exercise |
Countries
Taiwan
Contacts
PRINCIPAL_INVESTIGATORWan Jung Kao, bachelor
staff
Outcome results
None listed