To investigate the effect of Neurodynamics Nerve flossing on femoral neuropathy in patients with haemophilia

Background: heamophilia is one of the serious chronic disorders in children and adolescents which results in less physical activities and restlessness hours than their peer.

HYPOTHESES:

This study will hypnotize that:

Neurodynamics Nerve flossing will have a significant effect on femoral neuropathy in patients with haemophilia

RESEARCH QUESTION:

will the Neurodynamics Nerve flossing has an effect on femoral neuropathy in patients with haemophilia?

Haemophilic patients with Femoral Neuropathy will be randomly divided in two equal groups control group which will receive conventional selected exercise program and study group will receive the same exercise training program in addition to Neurodynamics Nerve flossing three times per week for three successive months.

The Evaluation will done pre and post interventions included:

femoral nerve motor conduction velocity, muscle test For Iliopsoas and Quadriceps muscles and Pain visual analogue scale.

Inclusion Criteria:

• hemophilia A or B, all the patients
• positive femoral nerve tension test
• the Manual muscle test for iliopsoas and quadriceps muscles in all patients not less than grade 2 according to the oxford scale
• the age ranging from (12:16) years
• all the participants will be able to communicate verbally ,obey commands and instructions and co-operate with testing and training protocols

Exclusion Criteria:

• any participants have auditory, visual and sever cardiac disorders
• Patients who have mild degree of hemophilia
• Patients who have joint, muscle bleeding or pain in the lower limb in the preceding 3 weeks
• patients with any other neurological disorders or musculoskeletal disorders or deformities of the lower limb.