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Hemophilia is a genetic bleeding disorder that commonly leads to knee hemarthrosis, causing pain, swelling, and reduced joint mobility in children. While standard treatments include clotting factor replacement and physiotherapy, additional non-invasive approaches are being explored. This study aims to evaluate the effects of photobiomodulation on knee hemarthrosis in male hemophilia patients aged 9-14 years. It focuses on determining whether this therapy can reduce pain and swelling and improve joint range of motion when used alongside
Hemophilia is a hereditary bleeding disorder characterized by a deficiency in clottingfactors VIII or IX, leading to spontaneous or trauma-induced internal bleeding, especially into muscles and joints. Knee hemarthrosis is among the most commonanddebilitating complications in pediatric hemophilia patients, contributing to chronicjoint pain, restricted mobility, and long-term deformities. Conventional management includes clotting factor replacement and physiotherapeutic interventions such as theRICE protocol. However, complementary, non-invasive strategies are increasinglybeing explored to enhance joint health and reduce recurrent bleeding episodes. Photobiomodulation (PBM), also known as low-level laser therapy (LLLT), has shown promising effects on reducing inflammation, promoting tissue repair, andmanaging musculoskeletal pain, but its role in managing hemarthrosis in hemophiliaremains underexplored. This quasi-experimental study aims to evaluate the effects of photobiomodulationonknee hemarthrosis in male hemophilia patients aged 9 to 14 years. The study will beconducted at Sundas Foundation, Sialkot, following ethical approval fromBASAR. Atotal sample size of 24 will be selected using non-probability convenient sampling.Patients will be receiving LLLT in addition to standard care for 10 minutes for 3 days a week after an acute internal bleed or swelling. The primary outcomes assessedwill include pain intensity (using the Visual Analogue Scale), swelling (using a measuringtape), and range of motion (measured with a goniometer). Data will be collectedpre- and post-intervention to observe the effectiveness of PBM in improving joint functionand reducing hemarthrosis severity. The data will be collected using SPSS version26.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| photobiomodulation | Experimental | The intervention involves the application of low-level laser therapy (LLLT), also referred to as photobiomodulation (PBM), using a diode laser device with the intensity in the range of 1 to 500 mW . The laser was applied in continuous-wave mode directly to the skin over the knee joint at multiple anatomical points, including the medial, lateral, superior, and inferior aspects of the patella, covering 8 to 9 specific locations. Total treatment time will be 10 minutes, delivered with a spot size 13 Effects of Photobiomodulation o knee hemarthosis in children with Hemophilia ranging from 0.04 to 0.07 cm². During the procedure, patients are positioned in a supine posture with the knee slightly flexed (20-30°) to allow optimal access to the target areas. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| photobiomodulation | Radiation | Photobiomodulation is a non-invasive therapy that uses low-level light (typically from lasers or LEDs) to stimulate cellular activity and promote healing. It works by enhancing mitochondrial function, increasing energy (ATP) production, and reducing inflammation. This therapy is commonly used for pain relief, tissue repair, and improving recovery in various clinical conditions. |
| Measure | Description | Time Frame |
|---|---|---|
| VAS | The Visual Analogue Scale (VAS) is a simple and widely used tool to measure a person's pain intensity. It typically consists of a 10 cm straight line, where: One end represents "no pain" (0) The other end represents "worst possible pain" (10) The patient is asked to mark a point on the line that best represents their level of pain. The distance from the "no pain" end to the marked point is then measured and recorded as the pain score. VAS is easy to use, quick, and effective for tracking changes in pain over time in both clinical and research settings. | 3rd Day |
| Measuring Tape | A measuring tape in physiotherapy is a simple, flexible tool used to assess body dimensions such as limb length, girth, and joint swelling. It helps therapists monitor changes over time, evaluate muscle atrophy or edema, and track patient progress during rehabilitation. | 3rd Day |
| Goniometer | A goniometer is a scientific instrument used to measure angles. It is commonly used in fields like geometry, engineering, and healthcare. In medicine-especially in physical therapy and orthopedics-it helps measure the range of motion of joints in the human body. A typical goniometer consists of a protractor-like scale with two arms that can be aligned along the body part or object to determine the angle accurately. | 3rd Day |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Imran Amjad, PhD | Contact | 03324390125 | imran.amjad@riphah.edu.pk | |
| Muhammad Asif Javed, PhD* | Contact | +923224209422 | a.javed@riphah.edu.pk |
| Name | Affiliation | Role |
|---|---|---|
| Zaira Zeeshan, MS | Riphah International University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sundas Foundation | Recruiting | Sialkot | Punjab Province | 5100 | Pakistan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31540851 | Background | Laccourreye O, Maisonneuve H. French scientific medical journals confronted by developments in medical writing and the transformation of the medical press. Eur Ann Otorhinolaryngol Head Neck Dis. 2019 Nov;136(6):475-480. doi: 10.1016/j.anorl.2019.09.002. Epub 2019 Sep 17. |
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| ID | Term |
|---|---|
| D006395 | Hemarthrosis |
| D006467 | Hemophilia A |
| ID | Term |
|---|---|
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D006470 | Hemorrhage |
| D010335 | Pathologic Processes |
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| ID | Term |
|---|---|
| D028022 | Low-Level Light Therapy |
| ID | Term |
|---|---|
| D053685 | Laser Therapy |
| D013812 | Therapeutics |
| D010789 | Phototherapy |
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|
| D013568 |
| Pathological Conditions, Signs and Symptoms |
| D025861 | Blood Coagulation Disorders, Inherited |
| D001778 | Blood Coagulation Disorders |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D020147 | Coagulation Protein Disorders |
| D006474 | Hemorrhagic Disorders |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |