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

NCT ID: NCT04308876

Last Updated: 2020-03-16

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 17 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2018-04-09
• Study Completion Date: 2020-02-06

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.

Conditions

Hemophilia; Arthritis

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Manual therapy and strengthening exercises

Manual therapy and strengthening exercises were applied totally 15 sessions for 5 weeks 3 times a week in hospital by physiotherapist.

Group Type: EXPERIMENTAL

Manual therapy

Intervention Type: OTHER

Manual therapy includes techniques applied to elbow joints and surrounding tissues

Strengthening exercises

Intervention Type: OTHER

Strengthening exercises used in this study includes resistant exercises to increase muscle strength of upper extremity

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.

Group Type: ACTIVE_COMPARATOR

Strengthening exercises

Intervention Type: OTHER

Strengthening exercises used in this study includes resistant exercises to increase muscle strength of upper extremity

Interventions

Manual therapy

Manual therapy includes techniques applied to elbow joints and surrounding tissues

Intervention Type: OTHER

Strengthening exercises

Strengthening exercises used in this study includes resistant exercises to increase muscle strength of upper extremity

Intervention Type: OTHER

Eligibility Criteria

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

• Minimum Eligible Age: 12 Years
• Maximum Eligible Age: 35 Years
• Eligible Sex: MALE
• Accepts Healthy Volunteers: No

Sponsors

Necmettin Erbakan University

OTHER

Sponsor Role: lead

Responsible Party

Ayse Merve Tat

Lecturer

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Filiz Can, Professor

Role: STUDY_CHAIR

Hacettepe University, Faculty of Physical Therapy

Ilgen Sasmaz

Role: STUDY_DIRECTOR

Cukurova University, Faculty of Medicine, Department of Pediatric Hematology

Locations

Cukurova University

Adana, Sarıcam, Turkey (Türkiye)

Countries

Turkey (Türkiye)

Other Identifiers

Necmettin Erb. Physiotherapy-1

Identifier Type: -

Identifier Source: org_study_id