Self‐monitoring has potential for home exercise programmes in patients with haemophilia

Abstract

Haemophiliacs who have had to keep a physically inactive lifestyle due to bleeding during childhood are likely to have little motivation for exercise. The purpose of this study is to clarify the effectiveness of the self-monitoring of home exercise for haemophiliacs. A randomized controlled trial was conducted with intervention over 8 weeks at four hospitals in Japan. Subjects included 32 male outpatients aged 26-64 years without an inhibitor who were randomly allocated to a self-monitoring group and a control group. Individual exercise guidance with physical activity for improvement of their knee functions was given to both groups. The self-monitoring materials included an activity monitor and a feedback system so that the self-monitoring group could send feedback via the Internet and cellular phone. The self-monitoring was performed by checking exercise adherence and physical activity levels, bleeding history and injection of a coagulation factor. Both groups showed significant improvements in exercise adherence (P < 0.001) and physical function such as the strength of knee extension (P < 0.001), range of knee extension (P < 0.001), range of ankle dorsiflexion (P < 0.01), a modified Functional Reach (P < 0.05) and 10 metre gait time (P < 0.01). In particular, improvements in exercise adherence (P < 0.05), self-efficacy (P < 0.05), and strength of knee extension (P < 0.05) were significant in the self-monitoring group compared with those in the control group. No increase in bleeding frequency and pain scale was noted. The self-monitoring of home exercise for haemophilic patients is useful for the improvement of exercise adherence, self-efficacy and knee extension strength.

Effectiveness of Physiotherapy in the Treatment of Hemophilic Arthropathy a Systematic Review

“…In a first phase, after discarding the 116 articles repeated among the various documentary sources, the titles and abstract of the remaining 67 studies were analyzed. Finally, following the selection process, only 10 articles [19][20][21][22][23][24][25][26][27][28] met the established criteria. Figure 1 shows the flow diagram with the selection made according to the criteria described above.…”

“…Finally, it should be noted that the use of monitored home exercises [20] presents a high effect size in the improvement Differential mortality in follow-up assessment (%) 3 0 0 0 0 Table 5 shows the results of the effect size calculation of the selected studies.…”

“…The development of home exercise programs and ergonomic bicycle and treadmill exercises to develop muscle strength, gait and proprioception were the most used therapeutic tools in the studies analyzed in the present review [19][20][21]24,25,27,28]. Joint traction (level I-II) and active and passive kinesitherapy are also used in the approach of hemophilic arthropathy [22,23].…”

“…On the other hand, two articles scored 8 points [22,25], the failure to describe the method of randomization being the main methodological deficiency. Three studies [20,21,24] scored 7 points, while one article scored 6 points [19], and only one [27] 5 points. This qualitative analysis presents medium-high scores due to proper randomization, the simple blind design and low experimental death, among other variables measured in the studies.…”

“…Similarly, five articles [20][21][22][23]25] scored 6 points out of 9, mainly as a result from not describing the method of randomization and comparison between groups. Finally, two articles [19,24] scored 5 points, the main methodological deficiencies being blinding and randomization, while another article only reached a score of 4 points [27].…”