Manual Therapy and Stretching Exercises Improve Joint Health Among Patients with Hemophilic Arthropathy

Manual therapy with passive muscle stretching exercises improves joint health, range of motions, and perceived joint pain, according to a study published in the journal Hemophilia.

Hemophilia is a recessive disease affecting mainly males. Hemophilic arthropathy refers to permanent joint disease occurring in hemophilia sufferers as a long-term consequence of repeated hemarthrosis. Haemarthroses may be spontaneous or result from minor trauma and typically first occurs before the age of two and continues to occur into adolescence. It is usual for the same joint to be repeatedly involved. One of the most affected joints in hemophilia patients is the knee.

With this background, a team of researchers led by Ruben Cuesta-Barriuso carried out a randomized single-blind clinical trial to evaluate the effectiveness of manual therapy and passive muscle stretching exercises for reducing the frequency of hemarthrosis and pain and improving joint health and range of motion in patients with hemophilic knee arthropathy.

28 patients with hemophilic knee arthropathy were randomized to an experimental group or to a control group. Manual therapy sessions included joint traction and gliding maneuvers, in addition to passive muscle stretching exercises. The intervention included one 60-minute session with two weekly sessions over a twelve-week period. The researchers evaluated the frequency of knee-hemarthrosis (self-reported), joint health (Hemophilia Joint Health Score), range of motion (goniometry), and perceived knee pain (visual analog pain). A baseline evaluation was performed after the intervention and after a twelve-week follow-up period.

The frequency of hemarthrosis dropped significantly in the experimental group compared to the control group, with better results for joint health, range of motion in joint flexion, extension, and pain.

"Manual therapy using joint traction and gliding maneuvers, in addition to passive muscle stretching reduces the frequency of hemarthrosis in patients with hemophilia. Manual therapy with passive muscle stretching exercises, improves joint health, range of motion and perceived joint pain," the researchers concluded.

References

• The study titled, "The effectiveness of manual therapy in addition to passive stretching exercises in the treatment of patients with hemophilic knee arthropathy: A Randomised Single blind Clinical Trial," is published in the journal Hemophilia.
• DOI: https://onlinelibrary.wiley.com/doi/epdf/10.1111/hae.14181