Self-myofascial Release in Hemophilic Ankle Arthropathy
Condition: Hemophilia
MeSH terms: Joint Diseases
Study type: Interventional

Summary: 
      Introduction: Hemophilic ankle arthropathy is manifested by degenerative functional
      alterations (deficit of muscle strength, mobility and proprioception) (intra-articular
      alterations) and chronic pain. Myofascial release techniques are used to treat soft tissue
      adhesions, relieve pain and reduce tissue sensitivity.

      Design. A randomized clinical trial. Aimed: To evaluate the safety and effectiveness of a
      protocol by self-myofascial release with Foam Roller applied in patients with hemophilic
      ankle arthropathy.

      Patients: 70 patients with ankle arthropathy will be recruited for inclusion in the study.
      Patients will be recruited in 5 centers, from different regions of Spain.

      Intervention: Each session will last approximately 15 minutes, with five physiotherapy
      sessions per week for a period of 3 months. Patients will be evaluated at baseline, after the
      intervention, and after a follow-up period of 3 months. The treatment program includes 11
      exercises that must be administered bilaterally. A mobile application will be developed where
      each patient will be able to observe the exercises to be carried out.

      Measuring instruments and study variables: digital goniometer (ankle range of motion); visual
      analog scale and pressure algometer (joint pain); Haemophilia Joint Health Score (joint
      status); dynamometer assess (muscle strength); 6-Minute Walking test (functionality of lower
      limbs); Mobile device (Activity record); Finger-floor test (muscle flexibility). At the same
      time, the study will allow to determine joint bleeding caused by applied physiotherapy
      treatment.

      Expected results: To demonstrate the safety of this Physiotherapy technique in patients with
      hemophilia. Likewise, an improvement in ankle pain, functionality and joint motion is
      expected.
    


Intervention name(s): Self-myofascial release
Intervention type(s): Other
Intervention description(s): At home, the patients performed a daily session, lasting 15 minutes each, over 8 weeks. Patients accessed an ad hoc mobile application designed by the Hemophilia Physiotherapy research group (He-Foam®). This app, accessible from any smartphone, made it possible to watch the videos with all the exercises included in the intervention. The seven exercises under the specific protocol for patients with hemophilic arthropathy were: Self-release of the plantar region of the foot with a foam ball; Release of the posterior region of the leg with the foam roller; Release of the anterior leg region with a foam roller; Release of the hamstrings region with a foam roller; Release of adductor muscles with a foam ball; Release of abductor muscles with a foam roller; Release of pelvic trochanteric muscles with a foam roller
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Hemophilic arthropathy; Ankle; Self-myofascial release; Safety; Joint pain; Functionality