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Rostami M, Sedaghati P, Daneshmandi H. The effectiveness of the STOP-X training program on the knee valgus angle and balance in female basketball players with dynamic knee valgus: a randomized controlled trial. BMC Sports Sci Med Rehabil 2024; 16:52. [PMID: 38383435 PMCID: PMC10882901 DOI: 10.1186/s13102-024-00844-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 02/08/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Dynamic knee valgus (DKV) accompanied by poor balance is the cause of anterior cruciate ligament (ACL) injury in athletes, and the identification and correction of these factors are always of interest to researchers. Therefore, the purpose of this research was to investigate the effect of the STOP-X program on the knee valgus angle and static and dynamic balance in female basketball players with DKV defects. METHODS The present study was a quasi-experimental study. Thirty female basketball players with DKV defects were purposefully identified by the single-leg landing (SLL) test and were randomly assigned to two control (n = 15) and experimental (n = 15) groups. Static balance status was evaluated with the BASS STICK test, and dynamic balance status was evaluated with the Y-balance test (YBT). The experimental group performed the STOP-X program for 25-40 min for eight weeks (three times per week), and the control group performed their traditional warm-up program. Data were analyzed by means of 2 × 2 repeated measures ANOVA followed by post hoc comparison (Bonferroni) at the significance level of (P < 0.05) with SPSS version 26. RESULTS The results showed that with the use of the STOP-X program, there was a significant difference between the experimental and control groups in variables of the static balance (F = 56.45; P = 0.001; ES = 0.66, PC=↑59.64%), total dynamic balance score (F = 107.57; P = 0.001; ES=↑0.79, PC=↑19.84%), and knee valgus angle (F = 119.46; P = 0.001; ES = 0.81, PC=↓34.36%). CONCLUSION In addition to reducing the knee valgus angle, applying the STOP-X injury prevention program can improve static and dynamic balance in female basketball players with DKV defects. Therefore, it can be recommended that sports trainers benefit from these advantages by adding STOP-X training to routine basketball exercises.
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Affiliation(s)
- Mohadeseh Rostami
- Department of Sport Injury and Corrective Exercise, Faculty of Sport Sciences, University of Guilan, Rasht, Iran
| | - Parisa Sedaghati
- Department of Sport Injury and Corrective Exercise, Faculty of Sport Sciences, University of Guilan, Rasht, Iran.
| | - Hassan Daneshmandi
- Department of Sport Injury and Corrective Exercise, Faculty of Sport Sciences, University of Guilan, Rasht, Iran
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2
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Xu H, Liu H. Effects of ankle isokinetic training on muscle strength and balance amongst older women with mild Parkinson's disease: A randomised trial. J Back Musculoskelet Rehabil 2024:BMR230259. [PMID: 38306022 DOI: 10.3233/bmr-230259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
BACKGROUND Patients with Parkinson's disease frequently experience problems with balance and gait. OBJECTIVE This study examined the influences of regular ankle isokinetic muscle strength training on muscle strength and balance ability amongst elderly women with mild Parkinson's disease. METHODS A total of 55 elderly women with mild Parkinson's disease were randomly divided into the experimental group (n= 28) and the control group (n= 27) for 16 weeks. The experimental group was trained for 16 weeks by using isokinetic muscle strength training. RESULTS After 16 weeks of training in the experimental group, the peak torque (PT) of ankle (average of the left and right sides) dorsiflexion, plantarflexion, eversion and inversion, and the standing balance index revealed that the left and right stability and overall stability indexes significantly increased by 25.9%, 43.5%, 62.7%, 82.8%, 37.1% and 32.2%, respectively (p< 0.05). The experimental group exhibited significantly increased PT of ankle dorsiflexion, plantarflexion, eversion and inversion. Moreover, the left and right stability and overall stability indexes were significantly improved compared with those of the control group (p< 0.05). This study found a linear regression relationship between the PT of ankle inversion and overall stability index. CONCLUSION This study determined that ankle isokinetic muscle strength training improved ankle dorsiflexion, plantarflexion, eversion and inversion muscle strength, and balance ability amongst elderly women with mild Parkinson's disease. However, it did not improve stability in the anterior and posterior directions. Ankle inversion muscle strength is more likely to affect overall balance.
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Affiliation(s)
- Hanxiao Xu
- College of Physical Education and Health, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Heng Liu
- College of Physical Education, Chongqing University, Chongqing, China
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Villalón-González M, Fernández de Luco-Santamaría Í, Cuesta-Barriuso R, López-Pina JA, Pérez-Llanes R. Hemophilic Arthropathy of the Knee and Its Association with Reduced Muscle Strength and Activation and the Pressure Pain Threshold: A Case-Control Study. J Clin Med 2023; 12:3275. [PMID: 37176715 PMCID: PMC10179255 DOI: 10.3390/jcm12093275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 04/29/2023] [Accepted: 05/03/2023] [Indexed: 05/15/2023] Open
Abstract
(1) Background: Hemophilia is characterized by recurrent hemarthrosis leading to degenerative arthropathy. The aim was to evaluate the differences in muscle strength and activity and the pressure pain threshold between patients with knee arthropathy and their healthy peers; (2) Methods: A case-control study in which 23 adult patients with knee arthropathy and 24 healthy peers matched in terms of characteristics were recruited. The study variables were quadriceps muscle strength, muscle activation and the pressure pain threshold; (3) Results: There were significant differences between the two groups in quadriceps strength on the dominant (CI95%: 64.69, 129.2) and non-dominant (CI95%: 29.95, 93.55) sides and in the pressure pain threshold on the dominant (CI95%: 3.30, 43.54) and non-dominant (CI95%: 3.09, 45.25) sides. There were differences in neuromuscular fatigue on the non-dominant side in the vastus medialis (CI95%: 8.72, 21.51), vastus lateralis (CI95%: 4.84, 21.66) and rectus femoris (CI95%: 6.48, 24.95) muscles; (4) Conclusions: Muscle strength and the pressure pain threshold are lower in patients with hemophilia. Quadriceps muscle activation in patients with hemophilic knee arthropathy does not in any way differ from activation in healthy subjects. However, muscle fatigue is greater in patients with knee arthropathy. Strength training in patients with hemophilia should focus on the activation of the vastus medialis and lateralis muscles.
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Affiliation(s)
| | | | - Rubén Cuesta-Barriuso
- Department of Surgery and Medical-Surgical Specialties, University of Oviedo, 33006 Oviedo, Spain
| | | | - Raúl Pérez-Llanes
- Department of Physiotherapy, Catholic University San Antonio-UCAM, 30107 Murcia, Spain; (Í.F.d.L.-S.); (R.P.-L.)
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4
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Elshennawy S, Zahreldin AA, Mortada H, Hozien M, Youssef ASA, Galal A, Shahien M, Elfeky A, Elaraby A, Hamed M. The Efficacy of Physical Therapy Modalities in Patients With Hemophilia: A Systematic Review of Randomized Controlled Trials With Meta-analysis. Arch Phys Med Rehabil 2023; 104:475-489. [PMID: 35868453 DOI: 10.1016/j.apmr.2022.05.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 04/27/2022] [Accepted: 05/05/2022] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To evaluate the efficacy of different physical therapy interventions that could validate decisions taken by health care providers in the field of rehabilitation of patients with hemophilia according to the International Classification of Functioning, Disability and Health (ICF), including body functions and structures, activity, and participation. DATA SOURCES Seven databases-PubMed, Cochrane Library, Scopus, Web of Science, Physiotherapy Evidence Database, Google Scholar, and Clinicaltrials.gov-were systematically searched for randomized controlled trials evaluating any physical therapy modality to manage hemophilia. STUDY SELECTION After abstract and full-text filtration, a methodological quality assessment was performed using the Physiotherapy Evidence Database scale for the studies that met the eligibility criteria. DATA EXTRACTION Relevant data were extracted from eligible studies and outcomes were categorized according to the ICF. DATA SYNTHESIS Using Review Manager and Microsoft Excel, a quantitative analysis using standardized mean differences with the 95% confidence interval was completed. Statistical heterogeneity between studies was explored using the I2 test. A fixed effect model was applied to all data analyses. If heterogeneity was statistically significant, the Der Simonian and Laird random effects models were used instead. RESULTS 35 randomized controlled trials with 1216 participants were included in this systematic review; 13 of them dealt with pediatric patients. Most of the studies were of good quality; 12 studies were of low quality. Meta-analysis showed a significant difference in favor of manual therapy, laser, and therapeutic exercises on selected outcomes of body function and structure, activity, and participation categories of the ICF model. CONCLUSION This systematic review recommends using manual therapy and therapeutic exercise modalities to improve join health status in combination with educational sessions to improve the quality of life of patients with hemophilic arthropathy. For pediatric patients with hemophilic arthropathy, using laser therapy is promising for improving functional capacity.
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Affiliation(s)
- Shorouk Elshennawy
- Faculty of Physical Therapy, Cairo University, Giza, Egypt; Faculty of Physical Therapy, Misr University for Science and Technology, Giza, Egypt
| | | | - Hossam Mortada
- Biomechanics Department, Faculty of Physical Therapy, Ahram Canadian University, Giza, Egypt
| | - Menna Hozien
- Department of Neurological Disorders and Surgery Faculty of Physical Therapy, Ahram Canadian University, Giza, Egypt
| | - Ahmed S A Youssef
- Faculty of Physical Therapy, Beni-Suef University, Beni-Suef, Egypt; Huazhong University of Science and Technology, Wuhan, China
| | - Amira Galal
- Faculty of Physical Therapy, Egyptian Chinese University, Cairo, Egypt
| | | | - Amr Elfeky
- Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | | | - Maged Hamed
- Faculty of Physical Therapy, Misr University for Science and Technology, Giza, Egypt.
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Taylor S, Toye F, Donovan-Hall M, Barker K. Past the tipping point: a qualitative study of the views and experiences of men with haemophilia regarding mobility, balance, and falls. Disabil Rehabil 2022; 44:7237-7245. [PMID: 34651530 DOI: 10.1080/09638288.2021.1988731] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE The life expectancy of people with haemophilia is increasing due to improved medical care. This improvement is accompanied by the co-morbidities of ageing, which include musculoskeletal degeneration and the associated effect on proprioception and balance. This study aims to explore the views and everyday experiences of those living with haemophilia regarding this. MATERIALS AND METHODS Nine people with moderate or severe haemophilia aged 43-58 years participated in semi-structured interviews and thematic analysis was used to examine the data. RESULTS Participants described pain and reduced movement in joints as a result of repeated bleeds, which caused problems with mobility and balance. Constant vigilance of their surroundings together with the potential consequences of bleeds caused continual worry. Participants were resourceful in their strategies to cope with the effects of haemophilia, to reduce pain and to minimise the risk of falling. However, participants felt stigmatised because of their condition. CONCLUSION People with haemophilia have difficulties with their mobility and balance that can increase their risk of falling. Healthcare professionals need to understand and address the physical and psycho-social factors that contribute to the risk of falls. A multi-disciplinary approach to devise effective strategies to counteract and monitor the risk of falls would be useful.Implications for RehabilitationHealthcare professionals should identify movements that are fearful and work on ways to increase confidence and ability to perform these.Healthcare professionals need to identify the recovery strategies used to maintain balance and build these movements into home exercise programmes.Effective pain reduction strategies, both pharmacological and non-pharmacological, need to be investigated and optimised.Footwear choice has implications for both pain reduction and balance and should be discussed in routine reviews.Optimising vision would maximise visual input to aid balance.
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Affiliation(s)
- Stephanie Taylor
- Oxford Haemophilia and Thrombosis Centre, Oxford University Hospital NHS Foundation Trust, UK
| | - Francine Toye
- Physiotherapy Research Unit, Nuffield Orthopaedic Centre, Oxford University Hospital NHS Foundation Trust, UK
| | | | - Karen Barker
- Physiotherapy Research Unit, Nuffield Orthopaedic Centre, Oxford University Hospital NHS Foundation Trust, UK.,Nuffield Department of Orthopaedics and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
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Gönen T, Yakut Y, Akbayram S. The effects of close kinetic chain exercises on proprioception and physical activity level in pediatric patients with hemophilia. Haemophilia 2022; 28:e189-e198. [PMID: 35921241 DOI: 10.1111/hae.14645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 07/14/2022] [Accepted: 07/14/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Knee joint proprioception is affected, and lower extremity functioning declines over time in patients with hemophilia A. AIM To investigate the effects of a structured exercise programme consisting of the close kinetic chain (CKC) exercises on proprioception and physical activity level in pediatric patients with hemophilia. METHODS A total of 21 patients with hemophilia A who had at least one target knee joint were randomized into three groups: Study Group (SG, n = 7), Conventional Treatment Group (CTG, n = 7) and Control Group (CG, n = 7). The SG received a structured, lower limb-specific exercise protocol consisting of CKC exercises 2 days a week for 12 weeks, in addition to prophylactic treatment. The CTG received exercise training as described in the published literature. The CG continued to receive prophylactic treatment during the study period. Proprioception was measured using a digital goniometer before and after treatment in open and closed kinetic chain positions (CKCPs). The Five Times Sit to Stand (STS), Timed Up and Go (TUG) and Functional Independence Score in Hemophilia were used for the assessment of physical activity level. RESULTS A significant pre/post-treatment difference was found among the groups in proprioception (p = .001) and physical activity level (TUG p = .008, STS p = .001, FISH p = .006). Improvements in proprioception and physical activity level were greater in the SG compared to the other two groups (p < .05). CONCLUSION Compared to conventional exercise, the structured exercise protocol consisting of CKC exercise training produced improvements in proprioception and physical activity in patients with hemophilia A.
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Affiliation(s)
- Tuğba Gönen
- Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Hasan Kalyoncu University, Gaziantep, Turkey
| | - Yavuz Yakut
- Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Hasan Kalyoncu University, Gaziantep, Turkey
| | - Sinan Akbayram
- Faculty of Medicine, Department of Pediatric Hematology-Oncology, Gaziantep University, Gaziantep, Turkey
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Chimeno-Hernández A, Querol-Giner F, Pérez-Alenda S, Núñez-Cortés R, Cruz-Montecinos C, Carrasco JJ, Aguilar-Rodríguez M. Effectiveness of physical exercise on postural balance in patients with haemophilia: A systematic review. Haemophilia 2022; 28:409-421. [PMID: 35363925 PMCID: PMC9325530 DOI: 10.1111/hae.14556] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/13/2022] [Accepted: 03/14/2022] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Balance training is important to improve balance and to decrease the risk of falls in patients with haemophilia (PWH). AIM To analyse the current knowledge about the effectiveness of physical exercise on postural balance in PWH. METHODS A systematic search for clinical trials, published before November 2021, was conducted using the following electronic databases: PubMed/MEDLINE, Web of Science, Embase, Wiley Online Library and the Cochrane Central Register of Controlled Trials (CENTRAL). Two independent reviewers extracted the data and assessed the risk of bias. The certainty of the evidence was analyzed using GRADE. RESULTS A total of ten studies involving 304 patients were included. The studies performed strength and balance exercises, and some included flexibility, mobilization, and/or aerobic exercises in their training programs. Postural balance was evaluated using a force platform and the one leg stand test was the most frequently used. Only five exercise programs achieved a significant increase in balance (pre-post) with a strength, postural balance, flexibility, and aerobic intervention. In general, the quality rate of the risk of bias was fair but the overall quality of the evidence across the studies was very low. CONCLUSION Five studies showed that there is a positive change in balance after the intervention. However, there is currently an unclear demonstration of evidence for the use of physical exercises to improve postural balance in people with haemophilia. Further studies with a higher methodological quality are needed.
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Affiliation(s)
- Ana Chimeno-Hernández
- Physiotherapy in Motion. Multispecialty Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain.,Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Felipe Querol-Giner
- Physiotherapy in Motion. Multispecialty Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain.,Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Sofía Pérez-Alenda
- Physiotherapy in Motion. Multispecialty Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain.,Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Rodrigo Núñez-Cortés
- Physiotherapy in Motion. Multispecialty Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain.,Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Carlos Cruz-Montecinos
- Physiotherapy in Motion. Multispecialty Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain.,Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile.,Division of Research, Devolvement and Innovation in Kinesiology, Kinesiology Unit, San José Hospital, Santiago, Chile
| | - Juan J Carrasco
- Physiotherapy in Motion. Multispecialty Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain.,Department of Physiotherapy, University of Valencia, Valencia, Spain.,Intelligent Data Analysis Laboratory, University of Valencia, Valencia, Spain
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8
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Tomschi F, Ransmann P, Hilberg T. Aerobic exercise in patients with haemophilia: A systematic review on safety, feasibility and health effects. Haemophilia 2022; 28:397-408. [PMID: 35226779 DOI: 10.1111/hae.14522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 02/12/2022] [Accepted: 02/14/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Haemophilia is a congenital bleeding disorder going along with disease-specific joint complications and general health implications attributed to the lack of daily movement. Recent guidelines recommend physical activity for people with haemophilia (PwH). Yet, aerobic exercise in PwH is little studied and seldomly prescribed by clinicans. AIM The aim of this systematic review is to investigate the safety, feasibility and health-related efficiency of AE in PwH. METHODS A systematic literature search according to the PRISMA guidelines was conducted (PubMed, Web of Science). Inclusion criteria were defined using PICOS. Methodological quality was assessed via TESTEX. RESULTS Out of 789 studies identified, seven studies (three randomized controlled, two controlled, two single-group prospective trails) were included. The TESTEX mean score was 8.1 (±3.8). AE was realized as aquatic exercise, nordic walking, treadmill running, bicycle riding and swimming. Neither bleeding rates nor the factor amount increased and AE led to diverse health-related improvements. CONCLUSIONS Little research has been conducted evaluating AE in PwH. Yet, AE can be considered as safe and feasible when being supervised by experts. However, disease-specific recommendations for AE are difficult to provide. Therefore, experts can currently only back AE recommendations on experience and nonhaemophilia-specific general guidelines.
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Affiliation(s)
- Fabian Tomschi
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany
| | - Pia Ransmann
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany
| | - Thomas Hilberg
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany
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9
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Ai D, Huang K, Li G, Zhen Y, Wu X, Zhang N, Huo A, Chen Z, Wu R. Exploration of the minimum necessary FVIII level at different physical activity levels in pediatric patients with hemophilia A. Front Pediatr 2022; 10:1045070. [PMID: 36389359 PMCID: PMC9665406 DOI: 10.3389/fped.2022.1045070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 10/13/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Physical activity can increase joint stability and reduce the risk of injury in hemophilia patients. There is limited clinical data on target trough FVIII levels during physical activity in hemophilia A patients. Hence, this study aimed to explore the target trough FVIII level required to avoid bleeding during different physical activities in hemophilia A patients. METHODS Patients with severe or moderate hemophilia A, who underwent pharmacokinetics (PK) tests at our center were enrolled in this study. Physical activities and clinical information such as bleeding were recorded. The FVIII level during physical activity was calculated by the WAPPS-Hemo. RESULTS A total of 105 patients were enrolled in this study. A total of 373 physical activities were recorded, of which 57.6% (215/373) was low-risk activities and the remaining 42.4% (158/373) was medium-risk activities. Most common physical activities were bicycling (59.0%), swimming (43.8%), running (48.6%), and jumping rope (41.0%). The FVIII trough level of low-risk physical activity was 3.8 IU/dl (AUC = 0.781, p = 0.002) and moderate-risk physical activity was 7.7 IU/dl (AUC = 0.809, p < 0.001). FVIII trough levels [low-risk activities: 6.1 (3.1, 13.2) IU/dl vs. 7.7 (2.3, 10.5) IU/dl, moderate-risk activities: 9.6 (5.8, 16.9) IU/dl vs. 10.2 (5.5, 11.0) IU/dl] were not statistically different between the mild arthropathy group and the moderate-severe arthropathy group. Multiple bleeding risk tended to increase with physical activities classified as moderate-risk (OR [95% CI]: 3.815 [1.766-8.238], p = 0.001). CONCLUSION The minimum necessary FVIII level increased with higher risk physical activity, irrespective of arthropathy.
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Affiliation(s)
- Di Ai
- Hematology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Kun Huang
- Hematology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Gang Li
- Hematologic Disease Laboratory, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Yingzi Zhen
- Hematology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xinyi Wu
- Hematology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Ningning Zhang
- Department of Radiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Aihua Huo
- Department of Radiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Zhenping Chen
- Hematologic Disease Laboratory, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Runhui Wu
- Hematology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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Kikuchi K, Komachi T, Honma Y, Fujitani J. Benefits of physical therapy for people living with hemophilia. Glob Health Med 2021; 3:409-412. [PMID: 35036624 PMCID: PMC8692092 DOI: 10.35772/ghm.2021.01026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/02/2021] [Accepted: 07/15/2021] [Indexed: 06/14/2023]
Abstract
This crossover study investigated effects of physical therapy (PT) on motor function in patients with hemophilia infected with human immunodeficiency virus (HIV) due to treatment with non-heat-treated blood products. Patients were randomly divided into a PT-first group (PT once monthly for 6 months, then only home exercise (HE) for 6 months) and an HE-first group (HE for 6 months, then PT once monthly for 6 months). Carryover, period, and treatment effects were examined. Carryover effect was observed for flexion muscle strength of the right hip joint and fast walking cadence. Period effect was observed for extension Range of motion (ROM) of the left hip joint, dorsiflexion of the right ankle joint, and fast walking cadence. PT tended to be effective for abduction of the left shoulder joint and fast walking cadence. Compared with HE, PT tended to contribute to improving ROM of the shoulder joints and fast walking.
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Affiliation(s)
- Kazuko Kikuchi
- Japan Foundation for AIDS Prevention, Tokyo, Japan
- Department of Rehabilitation Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Toshiharu Komachi
- Department of Rehabilitation Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yoshinori Honma
- Department of Rehabilitation Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Junko Fujitani
- Department of Rehabilitation Medicine, National Center for Global Health and Medicine, Tokyo, Japan
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11
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Promoting Sports Practice in Persons with Hemophilia: A Survey of Clinicians' Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211841. [PMID: 34831596 PMCID: PMC8625842 DOI: 10.3390/ijerph182211841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/04/2021] [Accepted: 11/06/2021] [Indexed: 11/16/2022]
Abstract
Historically, people with hemophilia have been warned to avoid physical activities as a possible cause of bleeding; however, currently, sport is considered necessary, especially in the developmental age, for providing a good quality of life. A survey was proposed to a group of hematologists and sports physicians working in Puglia, Italy, to explore their approach to physical activities for their patients with hemophilia and to obtain suggestions about possible interventions to promote the access of patients to sports. The survey was answered by 6 hematologists and 15 sports physicians. In total, 71% (about six patients/year/physician) of patients with hemophilia seen by sports physicians asked for counseling about sports, and 67% (about five patients/year/physician) actually practiced sports. On the other hand, only 31% (about 16 patients/year/hematologist) of patients asked hematologists questions on sports, and only 16% (about seven patients/year/hematologist) of patients with hemophilia and that were followed-up by hematologists practiced sports. The sports most often recommended to patients with hemophilia by physicians included swimming, athletics, tennis, running and gymnastics. According to hematologists, physical activity was very efficient in improving the quality of life of patients; stability of joints; their psychological, social and musculoskeletal wellbeing; and in reducing the risk of bleedings. On the other hand, physical activity was considered less important in all these areas by sport physicians. In conclusion, answers to this survey suggested that sports could be promoted among hemophilic patients by increasing the sports physicians' knowledge about hemophilia and their special role in this area. In addition, interviewed clinicians were of the opinion that increased awareness of specific guidelines and clinical practice protocols among both hematologists and sports physicians could be beneficial. Finally, answers suggested that access to fitness certification should be facilitated.
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12
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Versloot O, van Balen EC, Hassan S, Schols SEM, Leebeek FWG, Eikenboom J, Coppens M, van Vulpen LFD, Smit C, Driessens MHE, van der Net J, Gouw SC, Fischer K. Similar sports participation as the general population in Dutch persons with haemophilia; results from a nationwide study. Haemophilia 2021; 27:876-885. [PMID: 34146370 PMCID: PMC8518501 DOI: 10.1111/hae.14366] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 05/27/2021] [Accepted: 06/09/2021] [Indexed: 01/20/2023]
Abstract
Introduction Although sports participation is advocated in people with haemophilia (PWH), detailed data concerning sports participation in Dutch PWH is lacking. Aim to assess sports participation in Dutch PWH (6‐65 years) compared to the Dutch general population (GP). Methods Data from a nationwide, cross‐sectional study in PWH were analysed. Sports participation (type, duration, frequency) was assessed by the Modifiable Activities Questionnaire (MAQ), limitations in activities using the (Paediatric) Haemophilia Activities List ((Ped)HAL). Sports in the two highest categories according to the National Hemophilia Foundation classification were considered high‐risk sports. Groups were compared using Chi‐square testing. Results A total of 524 Adult PWH (median age: 45 (IQR: 30–55); 37% severe) and 126 paediatric PWH (median age: 11 (IQR: 8–14); 52% severe) were included. Sports participation was higher in adults (70%) than the GP (58%) and similar to the GP in children (PWH: 68%, GP: 72%). High‐risk sports participation decreased with age in PWH: from 65% (6‐12 years) to 17% (50‐65 years), which was also observed in the GP. Sports participation in children was independent of severity (non‐severe: 67% vs. severe: 65%; P = 0.97), but not in adults (non‐severe: 75%, severe: 62%; P < 0.01). Non‐severe PWH played more high‐risk sports than severe PWH: children at 65% vs. 48% (P = 0.05), adults at 25% vs. 15% (P = 0.07). Discussion These results suggest that sports participation in PWH was comparable to the GP. Sports participation was dependent of haemophilia severity in adults. Children were more involved in high‐risk sports than adults. More studies on sports‐related injury‐risk are needed for adequate counselling.
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Affiliation(s)
- Olav Versloot
- Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Erna C van Balen
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Shermarke Hassan
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Saskia E M Schols
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands.,Hemophilia Treatment Center Nijmegen-Eindhoven-Maastricht, Nijmegen, The Netherlands
| | - Frank W G Leebeek
- Department of Hematology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jeroen Eikenboom
- Department of Internal Medicine, Division of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - Michiel Coppens
- Department of Vascular Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Lize F D van Vulpen
- Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Cees Smit
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Janjaap van der Net
- Center for Child Development, Exercise and Physical Literacy, University Children's Hospital, University Medical Center, Utrecht, The Netherlands
| | - Samantha C Gouw
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Pediatric Hematology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Kathelijn Fischer
- Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands
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- Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands
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13
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Calatayud J, Martín-Cuesta J, Carrasco JJ, Pérez-Alenda S, Cruz-Montecinos C, Andersen LL, Querol-Giner F, Casaña J. Safety, Fear and Neuromuscular Responses after a Resisted Knee Extension Performed to Failure in Patients with Severe Haemophilia. J Clin Med 2021; 10:jcm10122587. [PMID: 34208148 PMCID: PMC8230803 DOI: 10.3390/jcm10122587] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/28/2021] [Accepted: 06/08/2021] [Indexed: 11/16/2022] Open
Abstract
Background: low–moderate intensity strength training to failure increases strength and muscle hypertrophy in healthy people. However, no study assessed the safety and neuromuscular response of training to failure in people with severe haemophilia (PWH). The purpose of the study was to analyse neuromuscular responses, fear of movement, and possible adverse effects in PWH, after knee extensions to failure. Methods: twelve severe PWH in prophylactic treatment performed knee extensions until failure at an intensity of five on the Borg CR10 scale. Normalised values of amplitude (nRMS) and neuromuscular fatigue were determined using surface electromyography for the rectus femoris, vastus medialis, and vastus lateralis. After the exercise, participants were asked about their perceived change in fear of movement, and to report any possible adverse effects. Results: Patients reported no adverse effects or increased fear. The nRMS was maximal for all the muscles before failure, the median frequency decreased, and wavelet index increased during the repetitions. The vastus lateralis demonstrated a higher maximum nRMS threshold and earlier fatigue, albeit with a lower and more progressive overall fatigue. Conclusions: severe PWH with adequate prophylactic treatment can perform knee extensions to task failure using a moderate intensity, without increasing fear of movement, or adverse effects.
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Affiliation(s)
- Joaquín Calatayud
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain; (J.C.); (J.M.-C.); (J.C.)
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark;
| | - Jonathan Martín-Cuesta
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain; (J.C.); (J.M.-C.); (J.C.)
| | - Juan J. Carrasco
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain; (S.P.-A.); (C.C.-M.); (F.Q.-G.)
- Intelligent Data Analysis Laboratory, University of Valencia, 46010 Valencia, Spain
- Correspondence: ; Tel.: +34-65-538-2100
| | - Sofía Pérez-Alenda
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain; (S.P.-A.); (C.C.-M.); (F.Q.-G.)
- Haemostasis and Thrombosis Unit, Universitary and Polytechnic Hospital La Fe, 46010 Valencia, Spain
| | - Carlos Cruz-Montecinos
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain; (S.P.-A.); (C.C.-M.); (F.Q.-G.)
- Laboratory of Clinical Biomechanics, Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago 8380453, Chile
| | - Lars L. Andersen
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark;
- Sport Sciences, Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark
| | - Felipe Querol-Giner
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain; (S.P.-A.); (C.C.-M.); (F.Q.-G.)
| | - José Casaña
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain; (J.C.); (J.M.-C.); (J.C.)
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14
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Calatayud J, Pérez-Alenda S, Carrasco JJ, Cruz-Montecinos C, Andersen LL, Bonanad S, Querol F, Megías-Vericat JE, Casaña J. Safety and Effectiveness of Progressive Moderate-to-Vigorous Intensity Elastic Resistance Training on Physical Function and Pain in People With Hemophilia. Phys Ther 2020; 100:1632-1644. [PMID: 32525975 DOI: 10.1093/ptj/pzaa106] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Revised: 10/24/2019] [Accepted: 04/16/2020] [Indexed: 02/09/2023]
Abstract
OBJECTIVE Strength training is recommended for people with hemophilia; however, published data are anecdotal and have methodological limitations. The purpose of this study was to evaluate the safety and effectiveness of progressive moderate-to-vigorous intensity elastic resistance training on physical function and pain in this patient population. METHODS A randomized controlled trial was conducted in a university laboratory setting where 20 patients (17 with severe, 1 with moderate, and 2 with mild hemophilia) aged 21 to 53 years received evaluations at baseline and 8-week follow-up. Participants were allocated to intervention (progressive strength training) or control (usual daily activities) groups. The intervention group trained 2 days per week during 8 weeks with elastic resistance. Intensity during the first 2 weeks was a 20-repetition maximum and increased progressively toward 15, 12, and finally 10 repetition maximum. The primary outcome was muscle strength. Secondary outcomes were the Timed "Up and Go" Test score, sit-to-stand, range of motion, Haemophilia Joint Health Score, kinesiophobia score, global impression of pain change, general self-rated health status, and desire to exercise. RESULTS The intervention group showed greater strength improvements than the control group in almost all of the joints, with moderate to high effect sizes. The intervention group also showed better Timed "Up and Go" and sit-to-stand scores than the control group (moderate effect size), greater range of motion at the knee flexion with the right leg (trivial effect size), and better Haemophilia Joint Health Score at the left knee (small effect size). The intervention group showed greater overall pain reduction, self-rated overall status, and desire to exercise than the control group. CONCLUSIONS Progressive strength training with elastic resistance performed twice a week during 8 weeks is safe and effective in people with hemophilia to improve muscle strength and functional capacity, reduce general pain, and improve self-rated health status and desire to exercise. IMPACT This study provides evidence for the use of a specific strength training regimen for people with hemophilia. LAY SUMMARY People with hemophilia of differing levels of severity, with adequate coverage with clotting factor, can safely engage in progressive strength training and can improve their functioning.
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Affiliation(s)
- Joaquín Calatayud
- Department of Physiotherapy, Exercise Intervention for Health Research Group, University of Valencia, Valencia, Spain; and National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Sofía Pérez-Alenda
- Department of Physiotherapy, Multispeciality Research Group, Physiotherapy in Motion, University of Valencia, Gascó Oliag 5, Valencia CP 46100 Spain; and Haemostasis and Thrombosis Unit, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Juan J Carrasco
- Department of Physiotherapy, Multispeciality Research Group, Physiotherapy in Motion and Intelligent Data Analysis Laboratory, University of Valencia
| | - Carlos Cruz-Montecinos
- Department of Physiotherapy, Multispeciality Research Group, Physiotherapy in Motion, University of Valencia and Department of Physical Therapy, Faculty of Medicine, Laboratory of Clinical Biomechanics, University of Chile, Santiago, Chile
| | - Lars L Andersen
- National Research Centre for the Working Environment and Department of Health Science and Technology, Sport Sciences, Aalborg University, Aalborg, Denmark
| | - Santiago Bonanad
- Haemostasis and Thrombosis Unit, University and Polytechnic Hospital La Fe
| | - Felipe Querol
- Department of Physiotherapy, Multispeciality Research Group, Physiotherapy in Motion, University of Valencia and Haemostasis and Thrombosis Unit, University and Polytechnic Hospital La Fe
| | - Juan E Megías-Vericat
- Haemostasis and Thrombosis Unit, University and Polytechnic Hospital La Fe and Pharmacy Department, Drug Clinical Area, University and Polytechnic Hospital La Fe
| | - José Casaña
- Department of Physiotherapy, Exercise Intervention for Health Research Group, University of Valencia
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15
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Versloot O, Timmer MA, de Kleijn P, Schuuring M, van Koppenhagen CF, van der Net J, Fischer K. Sports participation and sports injuries in Dutch boys with haemophilia. Scand J Med Sci Sports 2020; 30:1256-1264. [PMID: 32246553 PMCID: PMC7317861 DOI: 10.1111/sms.13666] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 02/26/2020] [Accepted: 03/24/2020] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Sports participation in children with hemophilia is generally considered to be associated with increased injury risk, which is generally considered highest in severe hemophilia. AIM To assess sports participation according to age and severity in children with hemophilia and its association with sports injuries. METHODS In a retrospective single-center study, sports participation, injuries, and bleeding data from three consecutive annual clinic visits were collected for young patients with hemophilia (PWH, aged 6-18). Sports in categories 2.5 and 3 of 3 according to the National Hemophilia Foundation classification were considered high-risk. Groups were compared using chi-square testing. RESULTS 105 PWH (median age: 13(IQR 10-14); 53% severe; bleeding rate: 1/y) were identified; three were unable to perform sports and were excluded. The majority of PWH (77%) played sports weekly, of which 80% high-risk sports. Sports participation (median 3.0x/wk), and the proportion of injured PWH was similar in severe (42%) and non-severe (33%) PWH. Sports injuries were rare (65% no injuries in 3 years, median 0/y (IQR 0-1)). Annually, PWH did not report more injuries (15%) than age-matched boys (28%). Sports injuries were not associated with frequency and type of sports. DISCUSSION This retrospective study showed high sports participation (including high-risk sports) and low injury rates. Sports participation was similar across severities and injury rates were not higher than among the general population. Injuries were not associated with frequency or type of sports. A prospective study with objective assessment of sports participation and injuries is warranted to confirm these findings and avoid recall bias.
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Affiliation(s)
- Olav Versloot
- Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Merel A Timmer
- Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Piet de Kleijn
- Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marleen Schuuring
- Center for Child Development, Exercise and Physical Literacy, University Children's Hospital, University Medical Center, Utrecht, The Netherlands
| | | | - Janjaap van der Net
- Center for Child Development, Exercise and Physical Literacy, University Children's Hospital, University Medical Center, Utrecht, The Netherlands
| | - Kathelijn Fischer
- Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands
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16
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Wagner B, Krüger S, Hilberg T, Ay C, Hasenoehrl T, Huber DFX, Crevenna R. The effect of resistance exercise on strength and safety outcome for people with haemophilia: A systematic review. Haemophilia 2020; 26:200-215. [PMID: 32091659 PMCID: PMC7155123 DOI: 10.1111/hae.13938] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 01/16/2020] [Accepted: 01/21/2020] [Indexed: 01/01/2023]
Abstract
Introduction Haemophilia is a congenital bleeding disorder with severe musculoskeletal complications. Resistance exercise is important to increase joint stability and to improve physical performance. Aim This review aimed to investigate the safety and efficacy of resistance exercise interventions on people with haemophilia (PwH) and evaluate whether the American College of Sports Medicine resistance exercise criteria for healthy adults are valid for this population. Methods A systematic search in literature was conducted, using the databases PubMed, MEDLiNE, CINAHL, SCOPUS, PEDro and Cochrane Library. Out of 2.440 studies published between 1960 and November 2019, 14 studies (9 randomized controlled trials, 1 controlled trial, 4 single‐group prospective studies) applying resistance exercise in juvenile and adult PwH corresponded to the inclusion criteria. Results Studies performed dynamic, isokinetic or a combination of isometric and dynamic resistance training. Most interventions were carried out in the context of a multimodal training. Resistance was provided using fixed and free weights, body weight, resistance bands and water resistance. Study protocols included clinical and home‐based settings. Several studies suggest that training intensities lower than those known to increase the strength of healthy people are effective in increasing the strength of PwH. Resistance exercise seems to be a safe intervention if it is adequately monitored, individually adapted and applied with sufficient factor therapy. Due to the heterogeneity of study designs, training interventions and outcome measures a meta‐analysis could not be performed. Conclusions Further studies of higher methodological quality are needed to determine the optimal types of exercise, optimal dosage and timing.
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Affiliation(s)
- Barbara Wagner
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Vienna, Austria
| | - Steffen Krüger
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany
| | - Thomas Hilberg
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany
| | - Cihan Ay
- Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Timothy Hasenoehrl
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Vienna, Austria
| | - Dominikus Franz-Xaver Huber
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Vienna, Austria
| | - Richard Crevenna
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Vienna, Austria
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17
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Wagner B, Seuser A, Krüger S, Herzig ML, Hilberg T, Ay C, Hasenöhrl T, Crevenna R. Establishing an online physical exercise program for people with hemophilia. Wien Klin Wochenschr 2019; 131:558-566. [PMID: 31535221 PMCID: PMC6851214 DOI: 10.1007/s00508-019-01548-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 08/06/2019] [Accepted: 08/22/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Hemophilia is a congenital bleeding disorder with an estimated frequency of 1:10,000 births. Repeated joint bleeding is a hallmark of the disorder and leads to painful hemophilic arthropathy. Regular exercise can help improve joint stability and function, reduce the risk of injury and bleeding and improve physical fitness and quality of life. This method paper describes an online training concept aiming to offer access to appropriate exercise instructions for people with hemophilia who are not able to attend regular training at a hemophilia center. METHODS The online exercise program is accessible through the homepage of the Department of Physical Medicine, Rehabilitation and Occupational Medicine of the Medical University Vienna as well as through scanning a QR code printed on information material using a smart phone or tablet. RESULTS The program contains exercises to improve mobility, coordination, muscular strength and flexibility. A brief introduction is given by a hematologist, a pediatrician and a physiatrist. An introductory video informs about contraindications and essential precautions, such as medical attendance and sufficient factor therapy to consider before starting the training. Another video gives advice on the exercise composition. The demonstrated exercises are explained by a physician and are available for adults and children. To individualize training recommendations and offer further diagnostic tools and physical treatment options as necessary, the Department of Physical Medicine, Rehabilitation and Occupational Medicine of the Medical University of Vienna will establish consultation hours for people with hemophilia. CONCLUSION As hemophilia is an orphan disease, patients are mainly treated in specialized centers. For patients who live far from these centers or have limited access to a training there for other reasons, the physical medicine consultation hour and the implementation of online exercise instructions offer individually adapted exercise information for a regular home-based training to benefit from increased physical fitness and joint stability.
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Affiliation(s)
- Barbara Wagner
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Axel Seuser
- Practice for Rehabilitation, Prevention and Orthopedics, Hans-Böckler-Straße 19, 53225, Bonn, Germany
| | - Steffen Krüger
- Department of Sports Medicine, University of Wuppertal, Moritzstraße 14, 42117, Wuppertal, Germany
| | - Marie Luca Herzig
- Department of Sports Medicine, University of Wuppertal, Moritzstraße 14, 42117, Wuppertal, Germany
| | - Thomas Hilberg
- Department of Sports Medicine, University of Wuppertal, Moritzstraße 14, 42117, Wuppertal, Germany
| | - Cihan Ay
- Department of Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Timothy Hasenöhrl
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Richard Crevenna
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
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18
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Witmer CM. How I approach managing student athletes at risk for bleeding. Pediatr Blood Cancer 2019; 66:e27523. [PMID: 30362247 DOI: 10.1002/pbc.27523] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 10/04/2018] [Accepted: 10/04/2018] [Indexed: 01/19/2023]
Abstract
Frequently, pediatric hematologists need to provide guidance regarding sports participation for children with congenital coagulopathies, immune thrombocytopenia, and those receiving anticoagulation. Although sports participation has clear health and psychosocial benefits, it can be associated with harm secondary to bleeding from injury. Decision-making for sports involvement should be individualized, patient centered, and well informed. This review focuses on the current data regarding the benefit as well as risks for sports participation and provides a framework for advising and supporting the student athlete who is at risk for bleeding.
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Affiliation(s)
- Char M Witmer
- The Children's Hospital of Philadelphia, Division of Hematology, Philadelphia, Pennsylvania
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19
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Neelapala Y, Attal R, Tandale S. Aquatic exercise for persons with haemophilia: A review of literature. Complement Ther Clin Pract 2019; 34:195-200. [DOI: 10.1016/j.ctcp.2018.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 12/07/2018] [Accepted: 12/13/2018] [Indexed: 02/01/2023]
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20
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Kurz E, Herbsleb M, Gabriel HHW, Hilberg T. Posturographic and ankle muscle activation characteristics in patients with haemophilia. Haemophilia 2018; 25:136-143. [PMID: 30520541 DOI: 10.1111/hae.13650] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 10/05/2018] [Accepted: 11/05/2018] [Indexed: 12/28/2022]
Abstract
INTRODUCTION The objective of this work was to examine the interrelations of posturographic and surface EMG (SEMG) characteristics of ankle muscles in patients with haemophilia while standing naturally. METHODS Surface EMG of five bilaterally recorded ankle muscles was conducted in 24 patients with haemophilia (PwH, age: 42 [11] years, mean [SD], 22 A, 2 B, 21 severe, 3 moderate) with median (quartiles) WFH orthopaedic joint score of 30 (20/39) points and 24 non-haemophilic controls (Con, age: 42 [12]). Force plate (IBS) signals were captured simultaneously during bipedal stance with eyes open. Load proportion of the left and right sides as well as heel and forefoot were calculated via four independent pressure transducers. Overall, weight distribution (WD) indices are reported with higher results representing a poorer WD. RESULTS Analyses of WD showed large differences between groups (PwH: 10.2 [5.4], Con: 5.2 [2.9], P < 0.001, d = 1.15). After clustering PwH, large effects (P = 0.02, ηp 2 > 0.16) were found for amplitude ratios of the lateral gastrocnemius (LG) muscle. In PwH, the degree of joint alteration of the right lower limb was associated with load proportion of the left side (ρ > 0.64, P = 0.001). CONCLUSION Patients with greater dysbalance showed higher forefoot loads and appeared to compensate their altered joint situations with considerably higher amplitude ratios of LG. Further studies should investigate whether therapeutic interventions could alter postural alignment and muscle activation and how these can influence patients' joint function and symptoms.
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Affiliation(s)
- Eduard Kurz
- Department of Orthopedic and Trauma Surgery, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.,Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany
| | - Marco Herbsleb
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena, Germany
| | - Holger H W Gabriel
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena, Germany
| | - Thomas Hilberg
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany
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21
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Hernandez G, Baumann K, Knight S, Purrington H, Gilgannon M, Newman J, Tobase P, Mathew S, Cooper DL. Ranges and drivers of risk associated with sports and recreational activities in people with haemophilia: results of the Activity‐Intensity‐Risk Consensus Survey of
US
physical therapists. Haemophilia 2018; 24 Suppl 7:5-26. [DOI: 10.1111/hae.13623] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 09/27/2018] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Susan Knight
- Children's Hospital of Los Angeles Los Angeles California
| | | | - Marc Gilgannon
- University of Virginia Health Systems Charlottesville Virginia
| | | | - Patricia Tobase
- University of California, San Francisco San Francisco California
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Elnaggar RK. Pedobarographic and stabilometric analysis and exercises for children with recurrent ankle haemarthrosis. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2018. [DOI: 10.12968/ijtr.2018.25.9.481] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Ragab Kamal Elnaggar
- Assistant professor, Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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23
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Hilberg T. Programmed Sports Therapy (PST) in People with Haemophilia (PwH) "Sports Therapy Model for Rare Diseases". Orphanet J Rare Dis 2018; 13:38. [PMID: 29506547 PMCID: PMC5836382 DOI: 10.1186/s13023-018-0777-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 02/15/2018] [Indexed: 12/30/2022] Open
Abstract
Sports and exercise therapy becomes more and more integrated in the treatment plan of different diseases. Although the benefits of this therapy are of high quality evidence, e.g. in cardiovascular diseases, no concepts of sports therapy are available as a treatment option for rare diseases. During the last eighteen years, we analyzed the situation as well as necessity, and developed a model, contents and the concept of the “Programmed Sports Therapy (PST)” for the treatment of PwH (people with haemophilia) as our model of rare disease. Many studies have shown that motoric skills are depressed in PwH, and that this gap to healthy people increases during age. The only way to reduce this progression is an appropriate therapy, adapted to the necessities of PwH. In haemophilia, in particular, physio- and sports therapy treatments should go hand in hand, the first in the acute phase after bleeding, the second later, after the acute phase has finished. One model, which considers all the different challenges, can be the cogwheel model presented here. Since haemophilia is a rare disease, new training concepts are necessary because classical group therapies are often impossible. PST based on the combination of sports therapy camps together with a supervised autonomous home training helps to directly bring the training to the trainee, in order to enhance key competences and improve the individual situation in PwH, and perhaps in patients with other rare diseases. The experience and scientific data substantiate the success of “Programmed Sports Therapy (PST)” and even this can be a model for other rare diseases.
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Affiliation(s)
- Thomas Hilberg
- Department of Sports Medicine, University of Wuppertal, Pauluskirchstr. 7, D-42285, Wuppertal, Germany.
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Donoso-Úbeda E, Meroño-Gallut J, López-Pina JA, Cuesta-Barriuso R. Safety and effectiveness of fascial therapy in adult patients with hemophilic arthropathy. A pilot study. Physiother Theory Pract 2018; 34:757-764. [DOI: 10.1080/09593985.2018.1425513] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
| | | | | | - Rubén Cuesta-Barriuso
- Department of Physiotherapy, European University of Madrid, Spain
- Real Fundación Victoria Eugenia, Madrid, Spain
- Fishemo CEE. Federación Española de Hemofilia, Madrid, Spain
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Franchini M, Mannucci PM. Modifiers of clinical phenotype in severe congenital hemophilia. Thromb Res 2017; 156:60-64. [PMID: 28599169 DOI: 10.1016/j.thromres.2017.05.038] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 05/31/2017] [Accepted: 05/31/2017] [Indexed: 02/06/2023]
Abstract
Patients with inherited hemophilia A and B usually exhibit a bleeding tendency of a severity proportional to the degree of plasmatic deficiency of the coagulant activity of factor VIII (FVIII:C) and factor IX (FIX:C). Although patients with severe hemophilia (i.e., with FVIII:C and FIX:C levels <1IU/dL) are generally those with the most severe bleeding phenotype, it is common experience that a variable proportion of them experiences a milder bleeding tendency. In this review, we summarize the current knowledge on the possible mechanisms at the basis of the phenotypic heterogeneity of severe hemophilia, focusing in particular on the role of FVIII/FIX gene mutations and thrombophilic polymorphisms. Finally, the possible therapeutic implications of such modifiers will be analyzed.
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Affiliation(s)
- Massimo Franchini
- Department of Transfusion Medicine and Hematology, Carlo Poma Hospital, Mantova, Italy.
| | - Pier Mannuccio Mannucci
- Scientific Direction, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
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Effectiveness of an Educational Physiotherapy and Therapeutic Exercise Program in Adult Patients With Hemophilia. Arch Phys Med Rehabil 2017; 98:841-848. [DOI: 10.1016/j.apmr.2016.10.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 10/04/2016] [Indexed: 11/21/2022]
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Oskay D, Ünal E, Leblebicioğlu G, Tuna Z. Effects of Exercise Training With Proprioceptive Equipment on Proprioceptive and Functional Status of Children with Obstetrical Brachial Plexus Injury. JOURNAL OF CLINICAL AND EXPERIMENTAL INVESTIGATIONS 2017. [DOI: 10.5799/jcei.328708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Astermark J, Hart D, Lobet S, Blatný J, d'Oiron R, Kenet G, Dolan G, Libotte V, Hermans C. Partnering to change the world for people with haemophilia: 6(th) Haemophilia Global Summit, Prague, Czech Republic, 24-26(th) September 2015. Eur J Haematol 2017; 97 Suppl 84:3-23. [PMID: 27292051 DOI: 10.1111/ejh.12761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The 6(th) Haemophilia Global Summit was held in Prague, Czech Republic, in September 2015. The programme was designed by an independent Scientific Steering Committee of haemophilia experts and aimed to share optimal management strategies for haemophilia at all life stages, explore recent potential advances in the management of haemophilia A and B and discuss challenges in haemophilia care. In this supplement from the meeting, Dan Hart reviews the lessons that can be learnt from cost-constrained environments with regard to improving care for people with haemophilia globally. Sébastien Lobet discusses the importance of physical activity for optimising care and Roseline d'Oiron and Jan Blatný consider the role of real-world data in understanding the effect of treatment in a clinical setting over the long term and the true impact of treatment on the day-to-day life of the patient. Gili Kenet addresses the current challenges relating to the optimal management of prophylaxis, and Gerry Dolan and Cedric Hermans discuss the value of pharmacokinetic (PK) parameters in informing treatment decisions. Cedric Hermans and Valérie Libotte explore the importance of considering social and occupational development factors as an integral part of haemophilia care, and Jan Astermark reviews key strategies to predict and prevent inhibitor development.
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Affiliation(s)
- Jan Astermark
- Department of Hematology and Vascular Diseases, Skåne University Hospital, Malmö, Sweden
| | - Dan Hart
- The Royal London Hospital Haemophilia Centre, Barts and The London School of Medicine and Dentistry, QMUL, London, UK
| | - Sébastien Lobet
- Haemostasis and Thrombosis Unit, Division of Haematology, Haemophilia Clinic, Saint-Luc University Hospital, Brussels, Belgium
| | - Jan Blatný
- Children's University Hospital Brno, Brno, Czech Republic
| | - Roseline d'Oiron
- Hôpital Bicêtre AP-HP, Paris XI University, Le Kremlin-Bicêtre, France
| | - Gili Kenet
- National Hemophilia Center, Sheba Medical Center, Tel HaShomer, Israel
| | | | - Valérie Libotte
- Service externe de prévention et de protection au travail - CESI - 1200 Brussels, Belgium
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Abstract
BACKGROUND Haemophilia is a bleeding disorder associated with haemorrhaging into joints and muscles. Exercise is often used to aid recovery after bleeds, and to improve joint function in the presence of arthropathy. OBJECTIVES Our objective was to systematically review the available evidence on the safety and effectiveness of exercise for people with haemophilia. SEARCH METHODS We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Coagulopathies Trials Register and electronic databases PubMed, OVID-Embase, and CINAHL. We hand searched abstracts from congresses of the World Federation of Hemophilia and the European Hematology Association, trial registries and the reference lists of relevant articles.Date of the last search of the Cochrane Cystic Fibrosis and Genetic Disorders Group's Coagulopathies Trials Register: 14 December 2016. SELECTION CRITERIA Randomized or quasi-randomized controlled studies comparing any exercise intervention considered relevant in haemophilia management including supervised, unsupervised, aquatic, strengthening, aerobic or cardiovascular, stretching, proprioceptive and balance training exercise programs in males of any age with haemophilia A or B of any severity (those with co-morbidities were not excluded). DATA COLLECTION AND ANALYSIS Two authors reviewed the identified abstracts to determine their eligibility. For studies meeting the inclusion criteria, full articles were obtained. The two authors extracted data and assessed the risk of bias. Any disagreements were resolved by discussion. The authors contacted study investigators to obtain any missing data. MAIN RESULTS Eight studies were included, which represented 233 males with all severities of haemophilia A and B, ranging in age from eight years to 49 years. Study duration ranged from four to 12 weeks. Exercise interventions varied greatly and included resistance exercises, isometric exercises, bicycle ergometry, treadmill walking and hydrotherapy; therefore, comparison between studies was difficult.None of the studies measured or reported adverse effects from the interventions. None of the studies reported outcomes regarding bleed frequency, quality of life or aerobic activity. Overall risk of bias across all studies was assessed as unclear.Very few studies provided sufficient information for comparison. None of the studies reported data that favoured the control group. One study reported that six weeks of resistance training improved joint health status (Colorado score) compared to controls. The addition of pulsed electromagnetic fields also improved ankle scores compared to exercises alone, but this was not seen in the elbows or knees.Two studies reported statistically significant improvements in pain intensity after exercise interventions compared to controls. Hydrotherapy exercises produced significant decreases in pain compared to controls and land-based exercise groups.Two studies found improvement in joint motion in the exercise group compared to controls. One study compared land- and water-based exercises; there was no difference in the range of motion between the two groups; however, the water-based exercise group did show improvement over the control group.One study, comparing joint traction and proprioceptive neuromuscular facilitation for the elbow to a control group, showed no differences in biceps girth or strength after 12 weeks of intervention.Some studies reported comparisons between interventions. In one study, treadmill training significantly improved balance in children compared to bicycle ergometry. Another study added partial weight bearing exercises to quadriceps exercises and showed improved walking tolerance.Four studies evaluated quadriceps or hamstring strength (or both). The addition of bicycle ergometry and exercises with weights was more effective than static exercises and treadmill walking for strengthening knee flexors and extensors. Partial weight-bearing exercises through range were more effective than static and short arc exercises for improving knee extensor strength. The addition of treadmill walking to ultrasound, stretching and strengthening exercises showed increased peak torque of knee flexors and extensors and decrease in knee effusion.The results should be interpreted with caution due to the quality of evidence (GRADE) as outlined in the summary of findings tables, which demonstrates that all but one of the outcomes assessed were rated as low or very low due to the small sample sizes and potential bias. AUTHORS' CONCLUSIONS These results must be considered with caution. There is a lack of confidence in the results due to the small number of included studies and the inability to pool the results due to the heterogeneity of outcome measures. Most exercise interventions produced improvement in one or more of the measured outcomes including pain, range of motion, strength and walking tolerance. Hydrotherapy may be more effective than land exercises for pain relief in adults. Functional exercises such as treadmill walking and partial weight bearing exercises seem to be more effective than static or short arc exercises for improving muscle strength. These findings are consistent with the many non-controlled intervention reports in the haemophilia literature. No adverse effects were reported as a result of any of the interventions. However, some groups used prophylactic factor prior to exercise and other groups studied only subjects with moderate haemophilia. Therefore, the safety of these techniques for persons with severe haemophilia remains unclear.
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Affiliation(s)
- Karen Strike
- Hamilton Health Sciences, McMaster Children's HospitalDepartment of Physiotherapy1200 Main Street WestHamiltonONCanadaL8N 3Z5
| | - Kathy Mulder
- Health Sciences CentrePhysiotherapy‐Child HealthCH246 ‐ 840 Sherbrook StreetWinnipegMBCanadaR3A 1S1
| | - Rojer Michael
- Manipal HospitalSchool of Allied Health SciencesOld Airport RoadBangaloreIndia560017
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Liu Y, Chen L, Zhao H, Zhang J. Analyses of joint health and influencing factors in different age groups of Chinese children with haemophilia. Haemophilia 2016; 22:e545-e548. [PMID: 27761965 DOI: 10.1111/hae.12983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Y. Liu
- Department of Physical Medicine and Rehabilitation; Peking Union Medical College Hospital; Chinese Academy of Medical Science; Beijing China
| | - L. Chen
- Department of Physical Medicine and Rehabilitation; Peking Union Medical College Hospital; Chinese Academy of Medical Science; Beijing China
| | - H. Zhao
- Department of Physical Medicine and Rehabilitation; Peking Union Medical College Hospital; Chinese Academy of Medical Science; Beijing China
| | - J. Zhang
- Department of Physical Medicine and Rehabilitation; Peking Union Medical College Hospital; Chinese Academy of Medical Science; Beijing China
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Runkel B, Von Mackensen S, Hilberg T. RCT - subjective physical performance and quality of life after a 6-month programmed sports therapy (PST) in patients with haemophilia. Haemophilia 2016; 23:144-151. [PMID: 27726259 DOI: 10.1111/hae.13079] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2016] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Musculoskeletal bleedings lead to limitations in the locomotor system and consequently, in health-related quality of life (HRQoL) in patients with haemophilia (PwH). Sports therapy is increasingly recommended to improve their physical performance. Until today, randomised controlled studies investigating changes in physical performance in PwH are rare. AIM This study investigates the impact of programmed sports therapy on the subjective physical performance and the HRQoL in PwH. METHODS A randomised controlled trial (RCT) was conducted with a training intervention for over 6 months. For this purpose, 64 PwH with moderate (n = 5) or severe (n = 59) haemophilia A (n = 57) or B (n = 7) were randomised into two groups - intervention (IG) or control group (CG). The HRQoL was assessed with the SF-36 questionnaire and the disease-specific Haem-A-QoL before and after the intervention. The subjective physical performance was tested by the HEP-Test-Q. RESULTS After the 6-month training intervention, PwH in the IG subjectively reported significant better 'endurance' (P = 0.000) in the HEP-Test-Q compared to the CG. In the SF-36, a significant difference in the domains 'general health perceptions' (P = 0.005) and 'mental health' (P = 0.001) was detected. The haemophilia-specific HRQoL questionnaire showed a significant improvement in the dimensions 'feeling' (P = 0.049), 'work' (P = 0.046) and 'family' (P = 0.040). CONCLUSION In the first RCT evaluating the impact of a 6-month training intervention on the subjective perception of PwH, an increase in subjective physical performance and some domains of HRQoL was demonstrated in the IG. Specific sports therapy should be included into the comprehensive treatment under supervision and monitoring by experienced staff.
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Affiliation(s)
- B Runkel
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany
| | - S Von Mackensen
- Institute of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - T Hilberg
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany
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de Kleijn P, Mauser-Bunschoten EP, Fischer K, Smit C, Holtslag H, Veenhof C. Evidence for and cost-effectiveness of physiotherapy in haemophilia: a Dutch perspective. Haemophilia 2016; 22:943-948. [DOI: 10.1111/hae.13076] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2016] [Indexed: 12/16/2022]
Affiliation(s)
- P. de Kleijn
- Van Creveld kliniek; University Medical Center Utrecht; Utrecht The Netherlands
- Physical Therapy Research; Department of Rehabilitation, Physiotherapy Science and Sports; Brain Center Rudolf Magnus; University Medical Center Utrecht; Utrecht The Netherlands
| | | | - K. Fischer
- Van Creveldkliniek; University Medical Center Utrecht; Utrecht The Netherlands
| | - C. Smit
- VSOP; Amsterdam The Netherlands
| | | | - C. Veenhof
- Physical Therapy Research; Department of Rehabilitation, Physiotherapy Science and Sports; Brain Center Rudolf Magnus; University Medical Center Utrecht; Utrecht The Netherlands
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Runkel B, Czepa D, Hilberg T. RCT of a 6-month programmed sports therapy (PST) in patients with haemophilia - Improvement of physical fitness. Haemophilia 2016; 22:765-71. [PMID: 27396815 DOI: 10.1111/hae.12957] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2016] [Indexed: 11/28/2022]
Abstract
UNLABELLED Physical fitness is of major importance for patients with haemophilia (PwH) but is highly influenced by bleeding episodes. Although some cohort studies describe an improvement of physical fitness after training intervention, randomized controlled studies (RCT) in PwH are still rare. AIM The aim of this study was to prove the enhancement of physical work capacity in PwH by programmed sports therapy (PST). METHODS This RCT includes a training period over six months. Sixty-four PwH with moderate (n = 5) to severe (n = 59) haemophilia A (n = 57) and B (n = 7) were randomized into two groups - training intervention group (IG) and control group (CG) by block randomization. Complex strength measurements, joint score, coordination check and a 12-min walking test were carried out before and after training intervention. RESULTS Significant differences were tested in M. triceps brachii (Δ+0.62 N kg(-1) ), biceps brachii (Δ+1.25 N kg(-1) ), latissimus dorsi (Δ+0.59 N kg(-1) ), rectus abdominis (Δ+0.51 N kg(-1) ), biceps femoris (right: Δ+0.68 N kg(-1) ; left: Δ+0.59 N kg(-1) ) and the quadriceps femoris (right: Δ+0.71 N kg(-1) ; left: Δ+0.55 N kg(-1) ) after intervention between the two groups (all p ≤ 0.003). Furthermore, an increase in distance (Δ+171.5 m) covered in the 12-min walking test (P = 0.011) was observed. Regarding one-leg stand, a significant improvement (P = 0.037) in the IG (Δ+2.2 s right leg) after intervention could be determined. CONCLUSION For the first time, a study with a corresponding number of adult PwH in a RCT-design showed that programmed sport therapy with specific instructions over 6 months has a positive effect on physical performance of PwH, independent of constitution and disease process.
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Affiliation(s)
- B Runkel
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany. ,
| | - D Czepa
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany
| | - T Hilberg
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany
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Krüger S, Weitz C, Runkel B, Hilberg T. Pain sensitivity in patients with haemophilia following moderate aerobic exercise intervention. Haemophilia 2016; 22:886-893. [DOI: 10.1111/hae.13016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2016] [Indexed: 12/29/2022]
Affiliation(s)
- S. Krüger
- Department of Sports Medicine; University of Wuppertal; Wuppertal Germany
| | - C. Weitz
- Department of Sports Medicine; University of Wuppertal; Wuppertal Germany
| | - B. Runkel
- Department of Sports Medicine; University of Wuppertal; Wuppertal Germany
| | - T. Hilberg
- Department of Sports Medicine; University of Wuppertal; Wuppertal Germany
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The effect of Nordic Walking on joint status, quality of life, physical ability, exercise capacity and pain in adult persons with haemophilia. Blood Coagul Fibrinolysis 2016; 27:467-72. [DOI: 10.1097/mbc.0000000000000554] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Schäfer GS, Valderramas S, Gomes AR, Budib MB, Wolff ÁLP, Ramos AAT. Physical exercise, pain and musculoskeletal function in patients with haemophilia: a systematic review. Haemophilia 2016; 22:e119-29. [PMID: 27075748 DOI: 10.1111/hae.12909] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2015] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Exercise can provide numerous benefits to haemophilia patients, including bleeding reduction in muscles and joints. AIM This systematic review (SR) aims to evaluate the effects of physical exercise on pain and the musculoskeletal function of patients with hemophilia. METHODS Literature searches of Pubmed, Web of Science, PEDro, Cochrane, Clinical Trials SciELO and Lilacs were performed. The risks of bias were measured using the JADAD scale. RESULTS Nine controlled clinical trials were included in the SR. CONCLUSION Physical exercise can promote a reduction in the perception of pain and can increase ROM and muscle strength in haemophilia patients. Future RCTs with greater methodological rigor that focus on the parameters used to prescribe exercises are necessary.
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Affiliation(s)
- G S Schäfer
- Resident of the Adult and Elderly Health Programme of the Clinics Hospital - Federal University of Paraná (HC/UFPR), Curitiba, PR, Brazil
| | - S Valderramas
- Internal Medicine Masters/Doctorate Programme of the Federal University of Paraná (UFPR), Multi-Professional Residency Programme in Health and Health Professions (HC/UFPR), Curitiba, PR, Brazil
| | - A R Gomes
- Master's/Doctorate Programme in Physical Education of the Federal University of Paraná (UFPR), Multi-Professional Residency Programme in Health and Health Professions (HC/UFPR), Curitiba, PR, Brazil
| | - M B Budib
- Resident of the Adult and Elderly Health Programme of the Clinics Hospital - Federal University of Paraná (HC/UFPR), Curitiba, PR, Brazil
| | - Á L P Wolff
- Multi-Professional Residency Programme in Health and Health Professions (HC/UFPR), Curitiba, PR, Brazil
| | - A A T Ramos
- Multi-Professional Residency Programme in Health and Health Professions (HC/UFPR), Curitiba, PR, Brazil
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Abstract
INTRODUCTION Sports activities are part of multidisciplinary treatments in people with hemophilia. AIM The objective of this study was to assess the incidence of sports activities in the quality of life as perceived by children with hemophilia. METHODS A total of 53 children with hemophilia aged 7 to 13 years and 51 children without hemophilia were evaluated. The perception of quality of life, clinical variables, and the frequency of sports activities were registered. The joint condition of patients with hemophilia was measured with the Spanish version of the Haemophilia Joint Health Score. RESULTS There were no significant differences in the perception of quality of life between children with hemophilia and children without hemophilia. Sports activities in people with hemophilia promoted a greater health satisfaction. CONCLUSIONS Sports activity in children with hemophilia is associated with an improved quality of life and joint health. It is also associated with improved psychosocial wellness.
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Valizadeh L, Hosseini FA, Zamanzadeh V, Heidarnezhad F, Jasemi M, Lankarani KB. Practice of Iranian Adolescents with Hemophilia in Prevention of Complications of Hemophilia. Indian J Palliat Care 2015; 21:328-37. [PMID: 26600702 PMCID: PMC4617041 DOI: 10.4103/0973-1075.164895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Prerequisite for management of a chronic disease involves knowledge about its complications and their prevention. Hemophilia in adolescents influences all the aspects of their lives and thier performance. OBJECTIVES The present study aimed to determine the performance of Iranian hemophilic adolescents in prevention of disease complications. PATIENTS AND METHODS In this descriptive-analytical study, 108 adolescents with hemophilia were selected through convenience sampling. Their performance in preventing the complications of hemophilia was evaluated by sending a semi-structured questionnaire to their addresses throughout Iran. Then, the data was analysed using the Statistical Package for Social Sciences (SPSS) software (v. 13) and descriptive and interferential statistics were used. RESULTS Overall, 32.1% of the participants controlled bleeding during the 1(st) hour. Inaccessibility of coagulation products was mainly responsible for inhibiting timely and proper bleeding control. In order to relieve bleeding associated pain, only 39.0% of the adolescents used analgesics. On the other hand, 19.8% of the subjects used nonpharmacological methods to relieve pain. The majority of the adolescents did not participate in sport activities (65.4%) others allocated less than 5 hours a week to physical activities (70.5%). In addition, the participants did not have favorable dietary patterns, exercise habits, and dental care. The results showed a significant relationship between the adolescents' preventive practice with coagulation disorders and utilization of pharmacological pain relief methods. Also, significant relationships were found between severity of the disease; participating in physical activities, number of hours of physical activities; and disease complications. CONCLUSIONS Iranian adolescents did not exhibit favorable practices towards complication prevention.
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Affiliation(s)
- Leila Valizadeh
- Department of Child and Family Health, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fahimeh Alsadat Hosseini
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Vahid Zamanzadeh
- Department of Medical-Surgical Nursing, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Heidarnezhad
- Department of Medical-Surgical Nursing, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Madineh Jasemi
- Department of Medical-Surgical Nursing, Urmia University of Medical Sciences, Urmia, Iran
| | - Kamran Bagheri Lankarani
- Department of Medical-Surgical Nursing, Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Astermark J, Dolan G, Hilberg T, Jiménez-Yuste V, Laffan M, Lassila R, Lobet S, Martinoli C, Perno CF. Managing haemophilia for life: 4th Haemophilia Global Summit. Haemophilia 2015; 20 Suppl 5:1-20. [PMID: 24924596 DOI: 10.1111/hae.12468] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The 4th Haemophilia Global Summit was held in Potsdam, Germany, in September 2013 and brought together an international faculty of haemophilia experts and delegates from multidisciplinary backgrounds. The programme was designed by an independent Scientific Steering Committee of haemophilia experts and explored global perspectives in haemophilia care, discussing practical approaches to the optimal management of haemophilia now and in the future. The topics outlined in this supplement were selected by the Scientific Steering Committee for their relevance and potential to influence haemophilia care globally. In this supplement from the meeting, Jan Astermark reviews current understanding of risk factors for the development of inhibitory antibodies and discusses whether this risk can be modulated and minimized. Factors key to the improvement of joint health in people with haemophilia are explored, with Carlo Martinoli and Víctor Jiménez-Yuste discussing the utility of ultrasound for the early detection of haemophilic arthropathy. Other aspects of care necessary for the prevention and management of joint disease in people with haemophilia are outlined by Thomas Hilberg and Sébastian Lobet, who highlight the therapeutic benefits of physiotherapy and sports therapy. Riitta Lassila and Carlo-Federico Perno describe current knowledge surrounding the risk of transmission of infectious agents via clotting factor concentrates. Finally, different types of extended half-life technology are evaluated by Mike Laffan, with a focus on the practicalities and challenges associated with these products.
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Affiliation(s)
- J Astermark
- Department of Hematology and Vascular Disorders, Skåne University Hospital, Malmö/Lund, Sweden
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Seuser A, Boehm P, Ochs S, Trunz-Carlisi E, Halimeh S, Klamroth R. How fit are children and adolescents with haemophilia in Germany? Results of a prospective study assessing the sport-specific motor performance by means of modern test procedures of sports science. Haemophilia 2015; 21:523-9. [DOI: 10.1111/hae.12636] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2014] [Indexed: 11/28/2022]
Affiliation(s)
- A. Seuser
- Private Practise for Prevention, Rehabilitation and Orthopedics; Bonn Germany
| | - P. Boehm
- Institute for Prevention and Aftercare; Cologne Germany
| | - S. Ochs
- Institute for Prevention and Aftercare; Cologne Germany
| | | | - S. Halimeh
- Coagulation Center Rhine-Ruhr; Duisburg Germany
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Aman JE, Elangovan N, Yeh IL, Konczak J. The effectiveness of proprioceptive training for improving motor function: a systematic review. Front Hum Neurosci 2015; 8:1075. [PMID: 25674059 PMCID: PMC4309156 DOI: 10.3389/fnhum.2014.01075] [Citation(s) in RCA: 168] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 12/30/2014] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Numerous reports advocate that training of the proprioceptive sense is a viable behavioral therapy for improving impaired motor function. However, there is little agreement of what constitutes proprioceptive training and how effective it is. We therefore conducted a comprehensive, systematic review of the available literature in order to provide clarity to the notion of training the proprioceptive system. METHODS Four major scientific databases were searched. The following criteria were subsequently applied: (1) A quantified pre- and post-treatment measure of proprioceptive function. (2) An intervention or training program believed to influence or enhance proprioceptive function. (3) Contained at least one form of treatment or outcome measure that is indicative of somatosensory function. From a total of 1284 articles, 51 studies fulfilled all criteria and were selected for further review. RESULTS Overall, proprioceptive training resulted in an average improvement of 52% across all outcome measures. Applying muscle vibration above 30 Hz for longer durations (i.e., min vs. s) induced outcome improvements of up to 60%. Joint position and target reaching training consistently enhanced joint position sense (up to 109%) showing an average improvement of 48%. Cortical stroke was the most studied disease entity but no clear evidence indicated that proprioceptive training is differentially beneficial across the reported diseases. CONCLUSIONS There is converging evidence that proprioceptive training can yield meaningful improvements in somatosensory and sensorimotor function. However, there is a clear need for further work. Those forms of training utilizing both passive and active movements with and without visual feedback tended to be most beneficial. There is also initial evidence suggesting that proprioceptive training induces cortical reorganization, reinforcing the notion that proprioceptive training is a viable method for improving sensorimotor function.
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Affiliation(s)
- Joshua E Aman
- Human Sensorimotor Control Laboratory, School of Kinesiology, University of Minnesota Minneapolis, MN, USA ; Center for Clinical Movement Science, University of Minnesota Minneapolis, MN, USA
| | - Naveen Elangovan
- Human Sensorimotor Control Laboratory, School of Kinesiology, University of Minnesota Minneapolis, MN, USA
| | - I-Ling Yeh
- Human Sensorimotor Control Laboratory, School of Kinesiology, University of Minnesota Minneapolis, MN, USA
| | - Jürgen Konczak
- Human Sensorimotor Control Laboratory, School of Kinesiology, University of Minnesota Minneapolis, MN, USA ; Center for Clinical Movement Science, University of Minnesota Minneapolis, MN, USA
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Niu X, Poon JL, Riske B, Zhou ZY, Ullman M, Lou M, Baker J, Koerper M, Curtis R, Nichol MB. Physical activity and health outcomes in persons with haemophilia B. Haemophilia 2014; 20:814-21. [PMID: 25156277 DOI: 10.1111/hae.12485] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2014] [Indexed: 11/30/2022]
Abstract
Regular participation in physical activity helps to prevent damage and maintain joint health in persons with haemophilia. This study describes self-reported physical activity participation among a sample of people with haemophilia B in the US and measures its association with health-related quality of life (HRQoL). Data on 135 participants aged 5-64 years were abstracted from Hemophilia Utilization Group Study Part Vb. The International Physical Activity Questionnaire assessed physical activity among participants aged 15-64 years, and the Children's Physical Activity Questionnaire abstracted from the Canadian Community Health Survey was used for participants aged 5-14 years. SF-12 was used to measure HRQoL and the EuroQol (EQ-5D-3L) was used to measure health status for participants older than 18 years of age. PedsQL was used to measure HRQoL in children aged 5-18 years. Sixty-two percent of participants in the 15-64 year-old age cohort reported a high level of physical activity, 29% reported moderate activity and 9% reported low activity. For children aged 5-14 years, 79% reported participating in physical activity for at least 4 days over a typical week. Based on the 2008 Physical Activity Guidelines for Americans, 79% of adults achieved the recommended physical activity level. Multivariable regression models indicated that adults who engaged in a high level of physical activity reported EQ-5D Visual Analogue Scale (VAS) scores that were 11.7 (P = 0.0726) points greater than those who engaged in moderate/low activity, indicating better health outcomes. Among children, no statistically significant differences in health outcomes were found between high and moderate or low activity groups.
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Affiliation(s)
- X Niu
- University of Southern California, Los Angeles, CA, USA
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43
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Brunner A, Stäuber F, Göhler S, Czepa D, Wendel M, Seuser A, Hilberg T. Impact of joint status on contraction steadiness of m. quadriceps femoris in people with severe haemophilia. Haemophilia 2014; 20:884-90. [DOI: 10.1111/hae.12493] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2014] [Indexed: 12/19/2022]
Affiliation(s)
- A. Brunner
- Department of Sports Medicine; University of Wuppertal; Wuppertal Germany
| | - F. Stäuber
- Department of Sports Medicine; University of Wuppertal; Wuppertal Germany
| | - S. Göhler
- Department of Sports Medicine; University of Wuppertal; Wuppertal Germany
| | - D. Czepa
- Department of Sports Medicine; University of Wuppertal; Wuppertal Germany
| | - M. Wendel
- Institute of Motion Analysis and Quality Control of the Locomotive System; Bonn Germany
| | - A. Seuser
- Institute of Motion Analysis and Quality Control of the Locomotive System; Bonn Germany
| | - T. Hilberg
- Department of Sports Medicine; University of Wuppertal; Wuppertal Germany
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Abstract
Numerous challenges confront adult hemophilia patients with inhibitors, including difficulty in controlling bleeding episodes, deterioration of joints, arthritic pain, physical disability, emotional turmoil, and social issues. High-intensity treatment regimens often used in the treatment of patients with inhibitors also impose significant scheduling, economic, and emotional demands on patients and their families or primary caregivers. A comprehensive multidisciplinary assessment of the physical, emotional, and social status of adult hemophilia patients with inhibitors is essential for the development of treatment strategies that can be individualized to address the complex needs of these patients.
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Affiliation(s)
- Sue duTreil
- Louisiana Center for Bleeding and Clotting Disorders, Tulane University Health Sciences Center, New Orleans, LA, USA
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45
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Eid MA, Ibrahim MM, Aly SM. Effect of resistance and aerobic exercises on bone mineral density, muscle strength and functional ability in children with hemophilia. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2014. [DOI: 10.1016/j.ejmhg.2013.12.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Cuesta-Barriuso R, Gómez-Conesa A, López-Pina JA. Manual therapy in the treatment of ankle hemophilic arthropathy. A randomized pilot study. Physiother Theory Pract 2014; 30:534-9. [DOI: 10.3109/09593985.2014.902148] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Al-Sharif FAG, Al-Jiffri OH, El-Kader SMA, Ashmawy EM. Impact of mild versus moderate intensity aerobic walking exercise training on markers of bone metabolism and hand grip strength in moderate hemophilic A patients. Afr Health Sci 2014; 14:11-6. [PMID: 26060452 DOI: 10.4314/ahs.v14i1.3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Patients with hemophilia A have low bone density than healthy controls. It is now widely recognized that physical activity and sports are beneficial for patients with hemophilia. OBJECTIVE To compare the effects of mild and moderate intensity treadmill walking exercises on markers of bone metabolism and hand grip strength in male patients with moderate hemophilia A. MATERIAL AND METHODS Fifty male patients with moderate hemophilia, and age range from 25 to 45 years. The subjects were randomly assigned into 2 equal groups; the first group (A) received moderate intensity aerobic exercise training. The second group (B) received mild intensity aerobic exercise training. RESULTS There was a 32.1% and 24.8% increase in mean values of serum calcium and hand grip strength respectively and 22.7 % reduction in mean values of parathyroid hormone in moderate exercise training group (A). While there was a 15.1 % and 15 % increase in mean values of Serum Calcium and Hand grip strength respectively and 10.3 % reduction in mean values of parathyroid hormone in mild exercise training group(B). The mean values of serum calcium and hand grip strength were significantly increased, while the mean values of parathyroid hormone were significantly decreased in both groups . There were significant differences between mean levels of the investigated parameters in group (A) and group (B) after treatment. CONCLUSION Moderate intensity aerobic exercise training on treadmill is appropriate to improve markers of bone metabolism and hand grip strength in male patients with hemophilia A.
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Affiliation(s)
- Fadwa Al-Ghalib Al-Sharif
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University
| | - Osama Hussien Al-Jiffri
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University
| | | | - Eman Mohamed Ashmawy
- Department of Physical Therapy, Faculty of Applied Medical Sciences, King Abdulaziz University
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Son SM, Kang KW, Lee NK, Nam SH, Kwon JW, Kim K. Influence of Isokinetic Strength Training of Unilateral Ankle on Ipsilateral One-legged Standing Balance of Adults. J Phys Ther Sci 2013; 25:1313-5. [PMID: 24259783 PMCID: PMC3820187 DOI: 10.1589/jpts.25.1313] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Accepted: 05/29/2013] [Indexed: 01/19/2023] Open
Abstract
[Purpose] The purpose of the current study was to investigate the changes in one-legged
standing balance of the ipsilateral lower limb following unilateral isokinetic strength
training. [Subjects and Methods] Thirty healthy adult volunteers were randomly assigned to
either a training group or a control group, so that each group included 15 subjects.
Subjects in the training group performed unilateral ankle isokinetic exercises of the
dominant leg using the Biodex 3 PRO System for a period of four weeks. Ipsilateral
one-legged standing balance was evaluated before and after the intervention with three
stability indexes of balance using the Biodex System: Anterior-Posterior Stability Index
(APSI), Medial-Lateral Stability Index (MLSI), and Overall Stability Index (OSI).
[Results] Comparison of pre- and post-test data revealed significant improvements in
strength values (dorsiflexion, plantarflexion, eversion, and inversion) and stability
indexes (APSI, MLSI, OSI). [Conclusion] These results suggest that ankle strengthening
exercise can be considered as a form of exercise that may assist individuals with
improvement of balance.
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Affiliation(s)
- Sung Min Son
- Department of Physical Therapy, College of Rehabilitation Science, Daegu University, Republic of Korea
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Parhampour B, Torkaman G, Hoorfar H, Hedayati M, Ravanbod R. Effects of short-term resistance training and pulsed electromagnetic fields on bone metabolism and joint function in severe haemophilia A patients with osteoporosis: a randomized controlled trial. Clin Rehabil 2013; 28:440-50. [PMID: 24249841 DOI: 10.1177/0269215513505299] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To assess the effects of short-term resistance training and pulsed electromagnetic fields on bone metabolism and joint function in patients with haemophilia with osteoporosis. DESIGN A randomized, controlled, patient and blood sample assessor-blinded, six-week trial, three times weekly. SETTING Hospital outpatients with severe haemophilia A and osteoporosis. SUBJECTS Forty-eight patients were randomly assigned to resistance training (RT, n = 13), combined resistance training with pulsed electromagnetic fields (RTPEMF, n = 12), pulsed electromagnetic fields (PEMF, n = 11) and control (n = 12) groups. INTERVENTION The RT group received 30-40 minutes of resistance exercises and placebo pulsed electromagnetic fields. The RTPEMF group received the same exercises with lower repetition and 30 minutes of pulsed electromagnetic fields. The PEMF group was exposed to 60 minutes of pulsed electromagnetic fields (30 Hz and 40 Gauss). MAIN MEASURES Bone-specific alkaline phosphatase, N-terminal telopeptide of type 1 collagen, and joint function, using the modified Colorado Questionnaire, were measured before and after the programme. RESULTS The absolute change of bone-specific alkaline phosphatase was significant in the RT and RTPEMF groups compared with the control group (25.41 ± 14.40, 15.09 ± 5.51, and -4.73 ± 2.93 U/L, respectively). The absolute changes in the total score for joint function were significant for knees, ankles, and elbows in the RT group (9.2 ± 1.38, 5.1 ± 0.5, and 3.2 ± 0.8, respectively) and the RTPEMF group (7.7 ± 1.0, 3.3 ± 0.6, and 2.5 ± 0.7, respectively) compared to the PEMF and control groups. This value was significant for knee joints in the PEMF group compared to the control group (3.4 ± 0.5 and 0.66 ± 0.4, respectively). CONCLUSIONS Resistance training is effective for improving bone formation and joint function in severe haemophilia A patients with osteoporosis.
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Zaky LA, Hassan WF. Effect of partial weight bearing program on functional ability and quadriceps muscle performance in hemophilic knee arthritis. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2013. [DOI: 10.1016/j.ejmhg.2013.02.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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