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This randomised controlled study was conducted to investigate the comprehensive physiotherapy combined with home exercises on individuals with hemophilic arthropathy in the lower extremity. There are two groups in the study: home exercises and comprehensive physiotherapy combined with home exercises. Is physiotherapy combined with home exercises superior to home exercises on joint health, bleeding frequency, reaction time, dynamic balance, muscle strength? The aim of this study is to increase the compliance of hemophilic individuals to physiotherapy and adapt home exercises to their lives with weekly sessions.
Introduction: The positive effects of physiotherapy and exercise on joint health, frequency of hemartrosis (FoH) in patient with hemophilic arhropathy (PwHA) are well explained in the literature. However, adaptation problems to physiotherapy sessions (usually 3 times a week) may cause PwHA to ignore the need for therapy. It may be more beneficial for PwHA to adapt physiotherapy and exercise into daily live.
Aim: To investigate the effect of a once-a-week physiotherapy combined with home exercises on joint health, FoH, muscle strength, pain, reaction time and dynamic balance.
Methods: 20 patients have hemophilic arthropathy in knee and/or ankle were randomly divided into 2 groups, named home exercise (HE) and comprehensive physiotherapy combined with home exercise (CPcwHE). In the clinical assessment, HJHS, manuel muscle tester, Fitlight® system for reaction time, functional reach test for dynamic balance were used and questioned the number of bleedings in the last 6 weeks for FoH. The CP group received comprehensive physiotherapy (manual therapy, neuromuscular electrical stimulation and exercises) 1 day a week, and did the exercises at home the other 2 days a week. The HE group performed the exercises given to CP at home 3 times a week. Evaluations were repeated at the end of 6 weeks.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Home exercise | Active Comparator | This group performed the same exercises given to comprehensive physiotherapy group at home 3 times a week for 6 weeks. |
|
| Comprehensive physiotherapy | Experimental | This group received comprehensive physiotherapy (manual therapy, neuromuscular electrical stimulation and exercises) 1 day a week, and did the exercises at home the other 2 days a week for 6 weeks. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Home exercise | Other | Home exercise are done at home without the supervision of a specialist. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Hemophilia Joint Health Score | Joint health (Max values= 84, min values=0. As the value increases, joint health worsens.) | 6 weeks |
| Reaction time | Dynamic balance | 6 week |
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Inclusion Criteria: -Clinical diagnosis of hemophilia
-Clinical diagnosis of hemophilic arthropathy in ankle and/or
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Ayse Merve Tat, Asst. Prof. | Van Yüzüncü Yıl University, Faculty of Health Science | Study Chair |
| Necati Muhammed Tat | Van Yüzüncü Yıl University, Faculty of Health Science | Principal Investigator |
| Serbay Şekeröz, Asst. Prof. | Van Yüzüncü Yıl University, Faculty of Health Science | Principal Investigator |
| Meryem M Büke, Asst. Prof. | Van Yüzüncü Yıl University, Faculty of Health Science | Principal Investigator |
| Kamuran M Karaman, Prof. | Van Yüzüncü Yıl University, Faculty of Medicine | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Van Yüzüncü Yıl University | Van | 65080 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40186132 | Derived | Tat AM, Tat NM, Sekeroz S, Buke M, Karaman K. Low frequency physiotherapy on joint health, hemarthrosis, walking, balance and reaction time in hemophilic arthropathy: a controlled trial. BMC Musculoskelet Disord. 2025 Apr 4;26(1):332. doi: 10.1186/s12891-025-08549-4. |
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Study Protocol and Statistical Analysis Plan
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| ID | Term |
|---|---|
| D006467 | Hemophilia A |
| D009043 | Motor Activity |
| D007592 | Joint Diseases |
| ID | Term |
|---|---|
| D025861 | Blood Coagulation Disorders, Inherited |
| D001778 | Blood Coagulation Disorders |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
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| ID | Term |
|---|---|
| D026201 | Musculoskeletal Manipulations |
| ID | Term |
|---|---|
| D000529 | Complementary Therapies |
| D013812 | Therapeutics |
| D026741 | Physical Therapy Modalities |
| D012046 | Rehabilitation |
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Randomised controlled study
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| Manual therapy | Other | Manual therapy is special techniques for soft tissues and joints applied by a physiotherapist. |
|
| Neuromuscular electrical stimulation | Device | Home exercise are done at home without the supervision of a specialist. Manual therapy is special techniques for soft tissues and joints applied by a physiotherapist. Neuromuscular electrical stimulation is the application of electrical current to the muscle through special electrodes in order to increase muscle strength. Supervised exercise is done under the supervision of a physiotherapist. |
|
| Supervised exercise | Other | Supervised exercise is done under the supervision of a physiotherapist. |
|
| D020147 | Coagulation Protein Disorders |
| D006474 | Hemorrhagic Disorders |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D001519 | Behavior |
| D009140 | Musculoskeletal Diseases |