Fascial Therapy in Elbow Hemophilic Arthropathy
Condition: Hemophilia
MeSH terms: Joint Diseases; Hemophilia A
Study type: Interventional

Summary: 
      Introduction: The common clinical manifestations of hemophilia are skeletal muscle bleeds,
      especially hematomas and hemarthrosis. Repeated episodes of joint bleeding in certain joints,
      causing a progressive joint deterioration. Secondary disorders to this joint degeneration
      include: biomechanical alterations, loss of range of movement and periarticular muscle
      atrophy.

      Design. A prospective, multicenter and longitudinal pilot study to evaluate the efficacy of a
      treatment protocol with fascial therapy applied in patients with hemophilic arthropathy of
      the elbow.

      Aimed: To evaluate the safety and efficacy of a physiotherapy treatment by fascial therapy in
      patients with hemophilic arthropathy of the elbow Patients: A total of 60 patients with
      hemophilia and prophylactic treatment will be recruited for inclusion in the study. Patients
      will be recruited in 6 centers, from different regions of Spain.

      Intervention: Each session will last approximately 50 minutes, with three physiotherapy
      sessions taking place over a period of 3 weeks. The treatment program includes 11 maneuvers
      that must be administered bilaterally:

      Measuring instruments and study variables: goniometric evaluation (range of movement); visual
      analog scale (joint pain); Haemophilia Joint Health Score (joint status); DASH Questionnaire
      (functionality of upper limbs); SF-36 Questionnaire (perception of quality of life). At the
      same time, the study will allow to determine joint bleeding caused by applied physiotherapy
      treatment.

      Expected results: First, it is intended to demonstrate the safety of this physiotherapy
      technique in patients with hemophilia. Likewise, an improvement in the perception of elbow
      pain and joint mobility is expected. An improved functionality of the upper limb is also
      foreseen and with it, an enhanced perception of quality of life of these patients.
    


Intervention name(s): Experimental group
Intervention type(s): Other
Intervention description(s): Longitudinal surface sliding maneuver over the superficial fascia in the anterior region of the arm and the forearm. Applied in 3 strokes.
Transverse sliding of the flexor muscles of the wrist and fingers.
Transverse sliding for the biceps brachii muscle.
Longitudinal surface sliding over the superficial fascia in the posterior arm region.
Transverse sliding over the brachial triceps tendon.
Transverse sliding for the pectoralis major muscle.
Transverse sliding for the posterior axillary region pectoralis major muscle.
Induction of the posterior axillary fold.
Induction (crossed hands over the brachial region and forearm).
Maneuver of transverse planes for the cervicothoracic region.
Upper limb telescopic maneuver.
Other intervention name(s): Fascial therapy group
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Hemophilia; Elbow; Arthropathy; Joint pain; Range of motion; Myofascial techniques; Safety patients; Quality of life; Functionality