Safety and efficacy of a self‐induced myofascial release protocol using a foam roller in patients with haemophilic knee arthropathy

Pérez-Llanes, Raúl; Donoso-Úbeda, Elena; Meroño-Gallut, Javier; Ucero‐Lozano, Roberto; Cuesta‐Barriuso, Rubén

doi:10.1111/hae.14498

Cited by 9 publications

(5 citation statements)

References 37 publications

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“…More than 40% of patients in our study reported an improvement exceeding the MDC in pressure pain threshold on the external malleolus, tibialis anterior muscle strength and range of motion. These values, although lower than those observed in other studies 45 should be interpreted from a clinical perspective. This intervention based on visualization of movement causes changes due to brain modulation.…”

Section: Discussioncontrasting

confidence: 75%

180‐degree immersive VR motion visualization in the treatment of haemophilic ankle arthropathy

et al. 2022

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Background: Patients with haemophilic arthropathy suffer chronic pain that affects and restricts their quality of life. Visualization of movement through immersive virtual reality is used for pain management. Aim:To evaluate the efficacy of 180-degree immersive VR motion visualization therapy in patients with haemophilic ankle arthropathy.Methods: Prospective, multicentre pilot study. Fifteen adult patients with bilateral haemophilic ankle arthropathy were recruited (mean age: 42.73 ± 12.36 years). The intervention lasted 4 weeks, with daily home sessions of 180-degree immersive motion visualization. The patients were given virtual reality glasses to use with their smartphones. From the YouTube mobile app® they accessed the recorded video with access from the He-Mirror App®. The study variables were joint state (Haemophilia Joint Health Score), pressure pain threshold (pressure algometer), muscle strength (dynamometry) and range of motion (goniometry). Three evaluations were performed: at baseline (T0), after the intervention (T1) and at the end of a 16-week follow-up period (T2). Results:No patient developed ankle hemarthrosis during the experimental phase. In the repeated measures analysis we found statistically significant differences in joint state (F = 51.38; η 2 p = .63), pressure pain threshold of the lateral malleolus (F = 12.34; η 2 p = .29) and range of motion (F = 11.7; η 2 p = .28). Conclusions: Therapy using immersive motion visualization does not cause hemarthrosis. This intervention can improve joint condition, pressure pain threshold and range of motion in patients with ankle arthropathy. Changes greater than the MDC were reported in more than 40% of patients for the variables pressure pain threshold, anterior tibialis strength and range of motion, which were considered clinically relevant.

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Section: Discussioncontrasting

confidence: 75%

180‐degree immersive VR motion visualization in the treatment of haemophilic ankle arthropathy

et al. 2022

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“…A recent cohort study 19 has shown the safety of myofascial self-release with foam rolling in patients with hemophilic knee arthropathy. This may be explained by the lower mechanical pressure exerted on the joint since foam rolling releases tension in the fascia.…”

Section: Discussionmentioning

confidence: 99%

“… 15 The use of myofascial self-release exercises has shown its effectiveness in reducing pain in patients with hip osteoarthritis 17 and plantar fasciitis, 18 also improving the range of motion in the latter case. Although a recent cohort study 19 has shown the safety and efficacy of a self-induced myofascial therapy protocol in patients with knee arthropathy, to date there have been no multicenter randomized clinical studies confirming the efficacy of this technique.…”

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confidence: 99%

Foam roller-based self-induced myofascial therapy in patients with hemophilic knee arthropathy: a multicenter, single-blind, randomized clinical study

DONOSO-ÚBEDA,

PÉREZ-LLANES,

MEROÑO-GALLUT

et al. 2024

Eur J Phys Rehabil Med

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BACKGROUND Hemophilia is a congenital coagulopathy characterized by degenerative joint damage. Self-induced myofascial therapy aims to decrease pain and improve tissue mobility, functionality and proprioception. AIM The aim of this study was to evaluate the safety and efficacy of self-induced myofascial release in patients with hemophilic knee arthropathy. DESIGN This is a randomized clinical study. SETTING This study was carried out in different patient associations. POPULATION Fifty-two patients with hemophilia were included in the study. METHODS Patients were randomized to the experimental group (daily home protocol of foam roller-based self-induced myofascial therapy for 8 weeks) or the control group (no intervention). The variables were the frequency of hemarthrosis (self-reporting), pain intensity (visual analog scale), range of motion (goniometry) and muscle strength (dynamometry). All variables were evaluated at baseline, post-treatment and after a 10-week follow-up. RESULTS The patients included in the experimental group showed significant improvements in terms of a decrease in frequency of hemarthrosis (mean difference [MD]=-0.61; 95% confidence interval [CI]: -0.81; -0.41) and pain intensity (MD=-0.33; 95% CI: -0.48, -0.18), increased range of motion (MD=0.88; 95% CI: 0.39; 1.37), strength in quadriceps (MD=0.88; 95% CI: 0.39; 1.37). (MD=12.39; 95% CI: 3.44; 21.34) and hamstrings (MD=7.85; 95% CI: 0.60; 15.11). There were intergroup differences in the frequency of hemarthrosis (F=14.51; P<0.001), pain intensity (F=9.14; P<0.001) and range of motion (F=13.58; P<0.001). CONCLUSIONS Self-induced myofascial therapy can be an effective complementary technique in the treatment of patients with hemophilic arthropathy. Self-induced myofascial therapy can reduce the frequency of knee hemarthrosis in patients with hemophilia. This technique can improve pain intensity and range of motion in patients with hemophilic knee arthropathy. CLINICAL REHABILITATION IMPACT Hemophilic knee arthropathy is characterized by chronic pain, decreased range of motion, and periarticular muscle atrophy. Foam roller-based self-induced myofascial therapy can reduce the frequency of hemarthrosis and pain intensity and improve range of motion in patients with hemophilic arthropathy. Foam roller-based self-induced myofascial therapy is safe and effective in the treatment of patients with hemophilia. The inclusion of self-induced myofascial therapy exercises in the approach to degenerative joint pathologies may be an effective and safe treatment option.

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“…It was measured in the sagittal plane under no-load pain-free conditions, with the patient in the supine position. The goniometer was positioned with its axis on the joint interline, the reference points being the longitudinal axis of the femur and fibula [ 30 ]. The higher the degrees, the greater the range of motion.…”

Section: Methodsmentioning

confidence: 99%

Approach to Knee Arthropathy through 180-Degree Immersive VR Movement Visualization in Adult Patients with Severe Hemophilia: A Pilot Study

Ucero‐Lozano

Pérez-Llanes

López‐Pina

et al. 2022

JCM

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(1) Background: Hemarthrosis is a typical clinical manifestation in patients with hemophilia. Its recurrence causes hemophilic arthropathy, characterized by chronic joint pain. Watching movement recorded from a first-person perspective and immersively can be effective in the management of chronic pain. The objective of this study was to evaluate the effectiveness of an immersive virtual reality intervention in improving the pain intensity, joint condition, muscle strength and range of motion in patients with hemophilic knee arthropathy. (2) Methods: Thirteen patients with hemophilic knee arthropathy were recruited. The patients wore virtual reality glasses and watched a flexion–extension movement of the knee on an immersive 180° video, recorded from a first-person perspective over a 28-day period. The primary variable was the pain intensity (visual analog scale). The secondary variables were the joint status (Hemophilia Joint Health Score), quadriceps and hamstring strength (dynamometry), and range of motion (goniometry). (3) Results: After the intervention period, statistically significant differences were observed in the intensity of the joint pain (Standard error [SE] = 19.31; 95% interval confidence [95%CI] = −1.05; −0.26), joint condition (SE = 18.68; 95%CI = −1.16; −0.52) and quadriceps strength (SE = 35.00; 95%CI = 2.53; 17.47). We found that 38.46% and 23.07% of the patients exhibited an improvement in their quadriceps muscle strength and joint condition above the minimum detectable change for both variables (8.21% and 1.79%, respectively). (4) Conclusions: One hundred and eighty degree immersive VR motion visualization can improve the intensity of joint pain in patients with hemophilic knee arthropathy. An intervention using immersive virtual reality can be an effective complementary approach to improve the joint condition and quadriceps strength in these patients.

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Safety and efficacy of a self‐induced myofascial release protocol using a foam roller in patients with haemophilic knee arthropathy

Cited by 9 publications

References 37 publications

180‐degree immersive VR motion visualization in the treatment of haemophilic ankle arthropathy

180‐degree immersive VR motion visualization in the treatment of haemophilic ankle arthropathy

Foam roller-based self-induced myofascial therapy in patients with hemophilic knee arthropathy: a multicenter, single-blind, randomized clinical study

Approach to Knee Arthropathy through 180-Degree Immersive VR Movement Visualization in Adult Patients with Severe Hemophilia: A Pilot Study

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