Physiotherapy interventions for pain management in haemophilia: A systematic review

McLaughlin, Paul; Hurley, Michael; Chowdary, Pratima; Khair, Kate; Stephensen, David

doi:10.1111/hae.14030

Cited by 28 publications

(38 citation statements)

References 37 publications

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“…Many reviews searched for current evidence of the effectiveness of physiotherapy interventions on musculoskeletal pain and function. [ 3 , 6 , 7 , 15 ] All authors agree on the multidisciplinary approach to patients with hemophylia, confirming the need for physiotherapy and its safety with respect to bleeding related to exercise, [ 7 ] but unclear conclusions are available with respect to the best intervention to recommend. [ 3 ] Most of the authors reported benefits by physiotherapy programs based on the recovery of flexibility, strength, balance, proprioception, and aerobic capacity both through land-based and aquatic exercise [ 8 , 10 , 14 , 16 ] as well by physical modalities (transcutaneous electrical nerve stimulation laser, ultrasounds, neuromuscular electrical stimulation, electromagnetic fields, and kinesiotaping) [ 5 , 17 , 18 ] and joint mobilizations.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of rehabilitation on pain and function in people affected by hemophilia

et al. 2021

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Introduction: Literature provides unclear evidence of the effectiveness of many physiotherapy interventions on pain intensity, quality of life, and functional ability in hemophilic patients, and suggests that rehabilitation programs should be focused on functional goals and the disability of patients. Aim: The aim of the present study is to present the outcome of a case series of patients with hemophilia in which a rehabilitation program has been carried out on the basis of a specific individual patient's functional impairment. Methods: Fifty-one patients were enrolled: 32 patients (Rehab Group) received a rehabilitative treatment, 19 patients for different reasons (living far from the hospital, family problems) did not receive rehabilitation (Control Group). The rehabilitation program was planned with respect to the emergent problems: musculoskeletal pain, joint range of motion limitation, muscle flexibility, walking difficulties, the appearance of hematomas/hemartro, and postural problems. All the patients were assessed at baseline (T0), after 1 month (T1), and after 3 months (T2) through visual analogic scale for musculoskeletal pain, the Hemophilia Joint Health Score for joint range of motion, the Functional Independence Score in Hemophilia for disability, and postural assessment by visual inspection. Results: A significant reduction of pain and improvement of Hemophilia Joint Health Score and Functional Independence Score in Hemophilia score was found in the Rehab Group along with the follow-up. Pain in the Control Group was lower with respect to the other group at baseline and significantly decreased after 1 month. Conclusion: A rehabilitation program focused on individual impairment of patients with hemophylia determined satisfying results in terms of pain control, functional, and disability improvement in 3 months follow-up.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of rehabilitation on pain and function in people affected by hemophilia

et al. 2021

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“…In the same way, the studies included in the meta‐analysis published in 2007 about the efficacy of psychological interventions in patients with arthritis underline the improvement in QoL achieved by CBT programmes for CP management 34,35 . Likewise, physiotherapy programmes to improve CP in chronic knee pain also obtained improvements in QoL 36 although a recent review states that there is no clear effect of physiotherapy in improving QoL in PwH 37 …”

Section: Discussionmentioning

confidence: 96%

Effects of a non‐pharmacological approach for chronic pain management in patients with haemophilia: efficacy of cognitive‐behavioural therapy associated with physiotherapy

et al. 2021

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Introduction More than half of adult patients with severe haemophilia (PWH) suffer pain daily, with chronic pain (CP) in more than 15% of cases, thereby reducing their quality of life (QoL). However, there are no evidence‐based therapeutic guidelines for pain management. Aim To evaluate the effectiveness of a combined protocol based on psychology and physiotherapy in the improvement of CP self‐efficacy in PWH with CP. Secondary outcomes are changes in QoL, emotional status, pain and kinesiophobia. Methods In this prospective controlled trial study, recruited patients were allocated either to an experimental group (EG, n = 10) or to a control group (CG, n = 9). EG received interventions over four months: one cognitive‐behavioural therapy (CBT) session per month and three home exercise sessions per week. Self‐efficacy (Chronic Pain Self‐Efficacy Scale), QoL (A36 Hemophilia‐QoL), emotional status (Hospital Anxiety and Depression Scale and Rosenberg's Self‐esteem Scale), pain (Visual Analogue Scale) and kinesiophobia (Tampa Scale for Kinesiophobia) were assessed at three time points (Week 0, Month 4 and Month 7). The intervention effects were determined with mixed 2‐factor ANOVAs. Results The EG showed a significant improvement (p < .05) in the control of symptoms and pain management scores on the Self‐Efficacy Scale, QoL, self‐esteem emotional status, pain and kinesiophobia. The intervention effects remained significant (p < .05) over time for pain management, QoL, pain and kinesiophobia. Conclusion The non‐pharmacological treatment applied based on CBT and physiotherapy showed to be effective in improving CP self‐efficacy, QoL and emotional status, while reducing pain and kinesiophobia in PWH with CP.

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“…After a bleed, the method “Protection, Optimal load, Ice, Compression, Elevation” (POLICE) is recommended first followed by the progressive reestablishment of muscle strength, starting with isometric exercises, concentric isotonic exercises, eccentric isotonic exercises, open kinetic chain and finally closed kinetic chain [ 8 , 9 , 10 , 11 ]. Manual therapy and exercise can be complemented with NMES, TENS, ultrasound, hydrotherapy, and gait reeducation, in addition to the use of therapeutic education to improve the quality of life and the perception of pain in these patients [ 12 , 13 , 14 ]. Moreover, chronic pain appears in 35–50% of people with hemophilia, with 40% of these patients indicating that health professionals do not treat their pain well, requiring a better approach from a biopsychosocial sphere [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…Manual therapy and exercise can be complemented with NMES, TENS, ultrasound, hydrotherapy, and gait reeducation, in addition to the use of therapeutic education to improve the quality of life and the perception of pain in these patients [ 12 , 13 , 14 ]. Moreover, chronic pain appears in 35–50% of people with hemophilia, with 40% of these patients indicating that health professionals do not treat their pain well, requiring a better approach from a biopsychosocial sphere [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

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Hemophilia Patient Experience in a Physical Therapy-Guided Health Education Intervention: A Mixed-Method Design

et al. 2021

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People with hemophilia usually have negative joint consequences due to their illness. Evidence suggests that exercise and therapeutic education bring some benefits. An important factor that affects health interventions was the experience and degree of satisfaction. Thus, it is relevant to analyze qualitative and quantitative data to obtain a complete view of the patient’s experience. As a result, a concurrent nested mixed method with quantitative predominance study design was carried out. Nine people with hemophilia of Hemoaralar with a homogeneous environment participated in this study. The items evaluated were the level of satisfaction through the GCPC-UN-ESU survey and the experience with healthcare interventions through a focus group. A high level of satisfaction was obtained, but some divergences between quantitative and qualitative data were found. Further research about physical therapy and this type of intervention in people with hemophilia should be considered to better address the impact of living with the disease.

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Physiotherapy interventions for pain management in haemophilia: A systematic review

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 28 publications

References 37 publications

Effectiveness of rehabilitation on pain and function in people affected by hemophilia

Effectiveness of rehabilitation on pain and function in people affected by hemophilia

Effects of a non‐pharmacological approach for chronic pain management in patients with haemophilia: efficacy of cognitive‐behavioural therapy associated with physiotherapy

Hemophilia Patient Experience in a Physical Therapy-Guided Health Education Intervention: A Mixed-Method Design

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