Security of the Myofascial Therapy in the Treatment of Hemophilic Arthropathy of the Knee and Ankle: A Pilot Study

Abstract

Introduction: Hemophilic arthropathy presents with chronic pain, muscle atrophy, loss of range of motion and proprioceptive disturbances. Myofascial therapy aims to improve mobility and joint pain mainly. The aim of this study is to evaluate the safety and efficacy of physiotherapy intervention by myofascial therapy in patients with hemophilic arthropathy of the knee and ankle.

Methods: Treatment consisted of three physiotherapy sessions (physiotherapy protocol described by Meroño‐Gallut et al.), in a period of three weeks, using techniques of myofascial therapy. The dependent variables were: security (registration of muscle and joint bleeding), joint mobility (goniometer), joint clinical status (HJHS) and joint pain (VAS).

Results: 16 patients (8 in each group) of mean age 40.69 years, participated in the study. Most they had hemophilia A (93.8%) and severe phenotype (75%). During the treatment period no patient in the experimental group had hemarthrosis in knees and ankles, while a patient in the control group reported a haemarthrosis in his left ankle. Improvements in the experimental group were observed in bilateral flexion knee, ankle plantar flexion, and ankle joint status. Finally found improvement in pain to the load in left ankle and right knee. In the control group no difference between the various assessments were observed.

Discussion/Conclusion: Miofascial therapy is safe in patients with hemophilic arthropathy of the knee and ankle. Although data and sample sizes are small myofascial therapy could improve mobility and joint pain in these patients. Clinical trials are needed with a larger sample to confirm the results pointing this pilot.