Effectiveness of Manual Therapy and Strengthening Exercises in Hemophilic Arthropathy of the Elbow Joint

Not Applicable

Completed

• Conditions: Hemophilia; Arthritis
• Interventions: Other: Manual therapy; Other: Strengthening exercises

• Registration Number: NCT04308876
• Lead Sponsor: Necmettin Erbakan University

Brief Summary

Manual treatment involves techniques based on the principles of moving the joint faces and separating the joint gap, and soft tissues mobilization techniques. The use of manual therapy in hemophilia is gradually increasing although it previously described as a contraindication. The utility and use of strengthening exercises in hemophilia has been going on for a long time. In this study, the effect of manual therapy and strengthening exercises joint was investigated in hemophilic arthropathy of the elbow.

Detailed Description

The aim of this study was to investigate the effects of strengthening exercises and manual therapy on bleeding frequency, pain, range of motion, muscle strength, arm circumference, joint health, functionality and quality of life in the physiotherapy and rehabilitation of hemophilic arthropathy of the elbow. Seventeen adolescent and young adult hemophilic individuals aged 12-30 years with elbow arthropathy were included in the study. The individuals were divided into the two groups via simple randomisation as Manuel Therapy and Exercise Group (MTEG) and Home Exercise Group (HEG). The individuals in HEG were given strengthening exercises as a home program. Those in the MTEG were applied manual therapy by the physiotherapist and were given supervised strengthening exercises. All treatments were performed 3 times a week for 5 weeks totally 15 sessions. Frequency of bleeding was evaluated with number of bleeding in the last 5 weeks. Numerical Pain Scale was used for activity and resting pain. Range of motion and muscle strength were measured with universal goniometer and digital dynamometer, respectively. The Quick-DASH questionnaire and Oxford Elbow Score were used for the functionality of the upper extremity and quality of life, respectively. The joint health status was evaluated with Hemophilia Joint Health Score-Elbow Point and Hospital for Special Surgery-Elbow Scoring System. Evaluations were made by the same physiotherapist before and after treatment.

Study Timeline

• Study Start: 2018-04-09
• Primary Completion: 2019-03-10
• Study Completion: 2020-02-06
• Status Verified: 2020-03
• Study First Submitted: 2020-03-12
• Study First Submitted QC: 2020-03-12
• Last Update Submitted: 2020-03-12
• Study First Posted: 2020-03-16
• Last Update Posted: 2020-03-16

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Male
• Target Recruitment: 17

Inclusion Criteria

• Having signs of hemophilic arthropathy in one or both elbow joints, Being between the ages of 12-30 (Adolescent and young adult), Receiving prophylactic factor replacement therapy.

Exclusion Criteria

• Having undergone any surgical procedure for elbow arthropathy, Having an orthopedic problem, such as a fracture, ligament or tendon injury, related to the upper limb in the past year, Receiving physiotherapy and rehabilitation for the elbow joint in the last 6 months

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Manual therapy and strengthening exercises	Strengthening exercises	Manual therapy and strengthening exercises were applied totally 15 sessions for 5 weeks 3 times a week in hospital by physiotherapist.
Manual therapy and strengthening exercises	Manual therapy	Manual therapy and strengthening exercises were applied totally 15 sessions for 5 weeks 3 times a week in hospital by physiotherapist.
Strengthening exercises	Strengthening exercises	Patients in this group performed the strengthening exercises given to the experimental group on their own at home with experimental group at the same time, frequency and dose.

Primary Outcome Measures

Name	Time	Method
Frequency of bleeding	5 week	It was evaluated wit bleeding number in elbow joint over last 5 week
Hemophilia Joint Health Score	5 week	We used the elbow point of Joint Health Status. Elbow Point is scored 0-20. A high score indicates that arthropathy findings worsen
Numerical Pain Scale	5 week	It was used for evaluation of activity and resting pain.

Secondary Outcome Measures

Name	Time	Method
Physical status of the elbow	5 week	Hospital for Special Surgery-Elbow Scoring System was used.
Functionality of the upper extremity	5 week	Quick-Disability of Arm, Shoulder and Hand questionnaire was used.
Range of motion	5 week	It was measured with universal goniometer.
Muscle strength	5 week	It was measured with digital dynamometer (Lafayette hand-held dynamometer)
Oxford Elbow Score	5 week	It was used for evaluation of Quality of life.

Trial Locations

Locations (1)

Cukurova University; 🇹🇷 Adana, Sarıcam, Turkey