Plyometric-Based Hydro-Kinesio Therapy in Children With Hemophilic Arthropathy
Condition: Haemophilic Arthropathy of Knee
MeSH terms: Joint Diseases
Study type: Interventional

Summary: 
      This study was designed to assess the effect of an 8-week plyometric-based hydro-kinesio
      therapy (Plyo-HKT) on pain, muscle strength, postural control, and functional performance in
      a convenience sample of children with hemophilic knee arthropathy (HKA). Forty-eight patients
      with HKA were randomly allocated to the Plyo-HKT group (n = 24, received the plyometric-based
      hydro-kinesio therapy program, twice/week, over 8 weeks) or the control group (n = 24,
      received standard exercise program). Both groups were assessed for pain, muscle strength,
      postural control, and functional performance pre and post-treatment.
    

Detailed description: 
      Forty-eight boys with moderate hemophilia-A were recruited from the hematology clinics of
      three large referral hospitals in Riyadh, Saudi Arabia. The study included patients who were
      8-16 years old, had factor VIII replacement prophylaxis, were clinically-stable cases, had
      unilateral knee hemarthrosis, had grade II or III knee arthropathy, had muscle strength of
      grade three, and if they were able to walk independently. Patients who had enduring disabling
      pain, fixed deformities, a history of musculoskeletal surgery, visual and/or vestibular
      deficits, or bleeding episodes within two weeks before enrollment were excluded.

      Outcome measures

      Pain: Pain during rest and/or movement was assessed using the Numerical Pain Rating Scale.

      Muscle strength: The peak concentric torque of the quadriceps and hamstring muscles was
      measured through an Isokinetic Dynamometer.

      Postural control: The directional dynamic limit of stability (forward, backward, affected,
      and non-affected) and overall limit of stability were assessed using the Biodex balance
      system.

      Functional performance: The extent of functional capacity was assessed through the functional
      independence score in hemophilia and the six-minute walk test.

      Interventions

      The Plyo-HKT group received the Plyo-HKT program, 45 minutes per session, two times a week
      for 8 consecutive weeks, in conformity with the National Strength and Conditioning
      Association guidelines and American Academy of Pediatrics safety standards. The Plyo-HKT
      program consisted of ten unilateral and bilateral lower limb plyometrics in the form of
      hopping/bounding/jumping activities conducted in a water medium. The Plyo-HKT included a
      warm-up for 10 minutes and a cool-down for 5 minutes. The control group received the standard
      exercise program, 45 minutes per session, two times a week for 8 consecutive weeks. The
      program consisted of flexibility exercise, strength training, weight-bearing, proprioceptive
      training, and free treadmill walking or cycle ergometry.
    

Intervention name(s): Plyometric-based hydro-kinesio therapy; Standard exercise therapy
Intervention type(s): Other; Other
Intervention description(s): The plyometric-based hydro-kinesio therapy was conducted for 45 minutes, twice weekly, for 8 successive weeks. The training was geared toward the lower body and was conducted under the close supervision of a licensed pediatric physical therapist in accordance with the safety performance guidelines defined by the American Academy of Pediatrics and the US National Strength and Conditioning Association.; The program encompassed the standard exercises for patients with JIA (aerobic, weight-bearing, proprioceptive, flexibility, and strengthening exercises). The training was conducted for 45 minutes, two times a week for 8 successive weeks.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: A prospective, randomized controlled clinical trial
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment