Aquatic exercise for persons with haemophilia: A review of literature

Neelapala, Y V Raghava; Attal, Radhika; Tandale, Shrishti

doi:10.1016/j.ctcp.2018.12.004

Cited by 9 publications

(20 citation statements)

References 28 publications

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“…Among the most cited, the comparisons were the effects of aquatic exercise versus no treatment, 21,25-27 and aquatic exercises versus exercise landbased, 6,21,25,28 and strengthening exercises versus no intervention 6,23,26,28 which were addressed in four reviews each. Among the most cited, the comparisons were the effects of aquatic exercise versus no treatment, 21,25-27 and aquatic exercises versus exercise landbased, 6,21,25,28 and strengthening exercises versus no intervention 6,23,26,28 which were addressed in four reviews each.…”

Section: Comparisonsmentioning

confidence: 99%

“…The buoyancy reduces the compressive forces of joint overload and allows exercises with decreased gravitational loading. However, while the positive effects of the viscoelastic properties of water promote resistance to movement due to drag forces, the results cannot be extrapolated as it is not yet clear whether the principles of strength training were applied during the exercise sessions 25,44. Aquatic exercises showed a reduction in pain indices in 4 of the 7 reviews that approached water as a means of exercise.…”

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confidence: 99%

“…Furthermore, the reduction in intra-articular pressure improves the mobility of the structure and favours movement 44. According to Neelapala et al,25 this may be due to methodological limitations, such as lack of a control group, randomization and blindness of the evaluators. Strike et al21 reviewed the available evidence on the safety and effectiveness of exercise for PWH and highlighted hydrotherapy as a more effective form of exercise compared to control groups and land exercises for pain relief in adults.Muscle strength was also one of the most cited variables in the reviews, being addressed in 4 of the 7 reviews that used aquatic exercises and described improved strength of patients undergoing the intervention.…”

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confidence: 99%

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Effects of exercise in people with haemophilia: An umbrella review of systematic reviews and meta‐analyses

2019

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Haemophilia is a genetic X-linked congenital haemorrhagic disorder characterized by a deficiency in the production of coagulation factors VIII and IX corresponding to haemophilia types A and B, respectively. 1,2 Although rare, with a frequency of 1 in 10 000 births, haemophilia can be found in about 400 000 people worldwide. 3 Approximately 85% of haemorrhagic episodes occur in the musculoskeletal system, hemarthroses and intramuscular haematomas, resulting in the main complications of haemophilia: pain, muscle atrophy and functional limitations that, in the long term, directly affect the performance of activities of daily living. 4,5 As a result, people with haemophilia (PWH) experience a more sedentary lifestyle, with lower muscle strength, aerobic and anaerobic endurance, and proprioception compared with healthy individuals. 6,7 A few decades ago, exercise was contraindicated for PWH due to low clotting factor concentrations and the high risk of bleeding.However, with the advent of concentrates for coagulation factor replacement as a form of treatment and prophylaxis to haemorrhages, Abstract Introduction: There is considerable evidence to indicate that exercise can have a positive impact on the treatment of people with haemophilia (PWH). However, there is a requirement for in-depth and comprehensive studies.Aim: This study aimed to analyse the evidence regarding the effects of exercise in PWH through an umbrella review of existing systematic reviews and meta-analyses.The secondary objective was to analyse the quality of the evidence.Methods: This umbrella review followed the PRISMA guidelines and was documented in the PROSPERO registry (CRD42019140785). We searched the PubMed, Web of Science, SPORTDiscus, Scopus, CINAHL and Cochrane Library databases.The methodological quality of the systematic reviews was assessed using AMSTAR 2.Results: Out of a total of 1030 systematic reviews, 10 fulfilled the criteria. Only one study was classified as high quality, and half of the selected studies were classified as low or critically low quality according to AMSTAR 2. Furthermore, most reviews investigated the effects of strength training and aquatic training, with positive results associated with low adverse events. Range of motion, strength and pain were the most investigated variables. All reviews showed overlapping studies. Conclusion:Exercise is an effective way to treat haemophilia and has a low incidence of related adverse events. However, caution is needed in the interpretation of the results due to half of the selected reviews showed low or critically low quality and only one have high quality. K E Y W O R D Sbleeding disorders, evidence-based practice, exercise, haemophilia, haemophilic arthropathy | 929 SIQUEIRA Et Al.

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Effects of exercise in people with haemophilia: An umbrella review of systematic reviews and meta‐analyses

2019

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“…The potential of aquatic exercise to build muscle strength due to viscosity and drag forces without any accompanying compressive force is another advantage. The compressive effect of hydrostatic pressure reduces swelling and pain …”

Section: Methodsmentioning

confidence: 99%

“…The compressive effect of hydrostatic pressure reduces swelling and pain. 20 Range of motion recovery in WR passes through passive and active exercises exploiting the floating effect on body segments and special floats applied on trunk and lower limbs. Given the buoyancy effect, and the fact that many exercises are performed in standing position, it is easier to work on joint flexion exercises for both patients and physiotherapists.…”

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confidence: 99%

Standard and water rehabilitation: An analysis of over 14 years' experience in patients with haemophilia or other clotting factor disorders after orthopaedic surgery

Passeri¹,

Martinelli²,

Gatteri³

et al. 2019

Haemophilia

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Introduction In people with haemophilia (PWH) with severe arthropathy, total joint replacement (TJR) can be undertaken if conservative management fails. Post‐operative rehabilitation treatment is an important part of the comprehensive management of patients undergoing TJR. Aim To compare post‐operative standard rehabilitation (SR) and SR plus water rehabilitation (WR) in PWH undergoing TJR. Methods PWH who were admitted to our centre between June 2003 and December 2016 for rehabilitation after TJR were included in the study. Rehabilitation included SR (ie, manual and mechanical mobilization, scar tissue massage, light muscle strengthening exercises and walking training with and without crutches) with or without WR. WR exercises with floats of different size and volume were performed when possible. Range of motion (ROM), muscle strength, pain level, perceived health status and length of hospital stay were analysed retrospectively. Results A total of 184 patients (233 rehabilitation programmes were enrolled in the study, corresponding to 160 after total knee replacement [TKR], 37 after total ankle replacement [TAR] and 36 after total hip replacement [THR]). Fifty‐eight (25%) patients were treated with WR in addition to SR (32 for TKR, 19 for TAR and 7 for THR) with an average of 5.7 hours of WR. Muscle strength, pain and perceived health status improved significantly after rehabilitation. Conclusion This non‐randomized study seems to indicate that WR plus SR improves muscle strength, pain and perceived health status more than SR alone in PWH undergoing TJR. It would be necessary, however, to carry out randomized comparative studies to confirm these provisional conclusions.

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Serious Blood Disorders: A Focus on Sickle Cell Disease and Hemophilia

Azar,

Gopal

2023

Palliative Care in Hematologic Malignancies and Serious Blood Disorders

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Aquatic exercise for persons with haemophilia: A review of literature

Cited by 9 publications

References 28 publications

Effects of exercise in people with haemophilia: An umbrella review of systematic reviews and meta‐analyses

Effects of exercise in people with haemophilia: An umbrella review of systematic reviews and meta‐analyses

Standard and water rehabilitation: An analysis of over 14 years' experience in patients with haemophilia or other clotting factor disorders after orthopaedic surgery

Serious Blood Disorders: A Focus on Sickle Cell Disease and Hemophilia

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