Results of feasibility and safety of randomised controlled trial of a musculoskeletal exercise intervention versus usual care for children with haemophilia

Bladen, Melanie; Carroll, Liz; Dodd, Charlene; Drechsler, Wendy I; Hashem, Ferhana; Patel, V. C.; Pellatt-Higgins, Tracy; Saloniki, Eirini-Christina; Stephensen, David

doi:10.1111/hae.14026

Cited by 5 publications

(9 citation statements)

References 10 publications

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“…A systematic review by Strike and colleagues 28 evaluating the safety and effectiveness of exercise for PWH found interventions including at least one resistance exercise, isometric exercise, bicycle ergometry, treadmill walking and hydrotherapy produced improvement in pain, range of movement (ROM), strength and walking tolerance. Subsequent randomized controlled studies have shown exercise to improve ROM, strength, walking tolerance, gait, balance, and quality of life, in addition to decreasing pain and anxiety 29–31 . In a more recent review of advances in musculoskeletal physiotherapy for haemophilia, Stephensen and colleagues concluded that exercise via its effect on pain, joint ROM, strength and mobility, can have a positive impact on maximizing mobility, function as well as improving quality of life, and that programmes incorporating hydrotherapy and functional exercise appear of most benefit 26 .…”

Section: Resultsmentioning

confidence: 99%

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European principles of care for physiotherapy provision for persons with inherited bleeding disorders: Perspectives of physiotherapists and patients

Kleijn¹,

Duport²,

Jansone³

et al. 2022

Haemophilia

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Introduction:In their Chronic Care Model, the World Health Organisation states that people with chronic disorders and their families should be informed about the expected course, potential complications, and effective strategies to prevent complications and manage symptoms. Physiotherapists are a key professional group involved in the triage, assessment and management of musculoskeletal conditions of persons with a bleeding disorder (PWBD). Nevertheless, recent reports describe access to physiotherapy for those with these conditions is only sometimes available.Aim: Access to high quality individualised physiotherapy should be ensured for all PWBD, including those with mild and moderate severities, male and female, people with von Willebrand Disease (vWD) and other rare bleeding disorders. Physiotherapy should be viewed as a basic requisite in their multidisciplinary care.Methods/ results: Following a series of meetings with physiotherapists representing the European Association for Haemophilia and Allied Disorders (EAHAD) and PWBD representing the European Haemophilia Consortium (EHC) and a review of This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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Section: Resultsmentioning

confidence: 99%

“…Subsequent randomized controlled studies have shown exercise to improve ROM, strength, walking tolerance, gait, balance, and quality of life, in addition to decreasing pain and anxiety. [29][30][31] In a more recent review of advances in musculoskeletal physiotherapy for haemophilia,…”

Section: Persons With a Bleeding Disorder Should Be Offered Assessmen...mentioning

confidence: 99%

European principles of care for physiotherapy provision for persons with inherited bleeding disorders: Perspectives of physiotherapists and patients

Kleijn¹,

Duport²,

Jansone³

et al. 2022

Haemophilia

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“…The Study Group (SG) received a structured exercise protocol comprising of CKC exercises. CTG received an exercise programme typically applied to PWH as reported in the literature, which consisted of active ROM, isometric, isotonic, balance and proprioception exercises 4,5 . Exercise training was applied 2 days a week for 12 weeks for both groups.…”

Section: Methodsmentioning

confidence: 99%

“…CTG received an exercise programme typically applied to PWH as reported in the literature, which consisted of active ROM, isometric, isotonic, balance and proprioception exercises. 4,5 Exercise training was applied 2 days a week for 12 weeks for both groups. Exercises were revised every 3 weeks to maintain interest and enhance the motivation of children with constant diversification of exercises 21 (Appendices 1 and 2).…”

Section: Interventionsmentioning

confidence: 99%

“…A review of studies on exercise interventions for PWH showed that mostly, range of motion (ROM), strengthening, aerobic training and aquatic exercises have been used for hemophilia. [3][4][5] Individualized exercise approaches often result in improvements in joint health and mobility, muscle strength and proprioception and also increase functionality. 6 The majority of rehabilitation approaches reported in the literature have addressed polyarticular involvement and studies demonstrating effectiveness of exercise training on a single joint are rare.…”

Section: Introductionmentioning

confidence: 99%

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The effects of close kinetic chain exercises on proprioception and physical activity level in pediatric patients with hemophilia

2022

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Introduction Knee joint proprioception is affected, and lower extremity functioning declines over time in patients with hemophilia A. Aim To investigate the effects of a structured exercise programme consisting of the close kinetic chain (CKC) exercises on proprioception and physical activity level in pediatric patients with hemophilia. Methods A total of 21 patients with hemophilia A who had at least one target knee joint were randomized into three groups: Study Group (SG, n = 7), Conventional Treatment Group (CTG, n = 7) and Control Group (CG, n = 7). The SG received a structured, lower limb‐specific exercise protocol consisting of CKC exercises 2 days a week for 12 weeks, in addition to prophylactic treatment. The CTG received exercise training as described in the published literature. The CG continued to receive prophylactic treatment during the study period. Proprioception was measured using a digital goniometer before and after treatment in open and closed kinetic chain positions (CKCPs). The Five Times Sit to Stand (STS), Timed Up and Go (TUG) and Functional Independence Score in Hemophilia were used for the assessment of physical activity level. Results A significant pre/post‐treatment difference was found among the groups in proprioception (p = .001) and physical activity level (TUG p = .008, STS p = .001, FISH p = .006). Improvements in proprioception and physical activity level were greater in the SG compared to the other two groups (p < .05). Conclusion Compared to conventional exercise, the structured exercise protocol consisting of CKC exercise training produced improvements in proprioception and physical activity in patients with hemophilia A.

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Proof of concept and feasibility of a blended physiotherapy intervention for persons with haemophilic arthropathy

et al. 2022

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Background: Regular physiotherapy with a physiotherapist experienced in the field is not feasible for many patients with haemophilia. We, therefore, developed a blended physiotherapy intervention for persons with haemophilic arthropathy (HA) (e-Exercise HA), integrating face-to-face physiotherapy with a smartphone application. Aim:The aim of the study was to determine proof of concept of e-Exercise HA and to evaluate feasibility.Methods: Proof of concept was evaluated by a single-case multiple baseline design.Physical activity (PA) was measured with an accelerometer during a baseline, intervention and post-intervention phase and analysed using visual inspection and a single case randomisation test. Changes in limitations in activities (Haemophilia Activities List [HAL]) and a General Perceived Effect (GPE) were evaluated between baseline (T0), post-intervention (T1) and 3 months post-intervention (T2) using Wilcoxson signed rank test. Feasibility was evaluated by the number of adverse events, attended sessions and open-ended questions.Results: Nine patients with HA (90% severe, median age 57.5 (quartiles 50.5-63.3) and median HJHS 32 (quartiles 22-36)) were included. PA increased in two patients. HAL increased mean 15 (SD 9) points (p = .001) at T1, and decrease to mean +8 points (SD 7) (p = .012) at T2 compared to T0. At T1 and T2 8/9 participants scored a GPE > 3.Median 5 (range 4-7) face-to-face sessions were attended and a median 8 out of 12 information modules were viewed. No intervention-related bleeds were reported. Conclusion:A blended physiotherapy intervention is feasible for persons with HA and the first indication of the effectiveness of the intervention in decreasing limitations in activities was observed.

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Results of feasibility and safety of randomised controlled trial of a musculoskeletal exercise intervention versus usual care for children with haemophilia

Cited by 5 publications

References 10 publications

European principles of care for physiotherapy provision for persons with inherited bleeding disorders: Perspectives of physiotherapists and patients

European principles of care for physiotherapy provision for persons with inherited bleeding disorders: Perspectives of physiotherapists and patients

The effects of close kinetic chain exercises on proprioception and physical activity level in pediatric patients with hemophilia

Proof of concept and feasibility of a blended physiotherapy intervention for persons with haemophilic arthropathy

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