Manual Fascial Therapy in Patients with Hemophilic Arthropathy
Fascial therapy is a rehabilitative technique that mobilizes the fascial complex using manual techniques with the goal of improving tissue mobility and function, as well as influencing pain. A team of experts from Spain evaluated the safety of this method in hemophiliacs with developed arthropathy in their study.
Study Objectives and Procedures
Hemophilia, especially in its most severe form, is characterized by a high risk of bleeding, particularly into the joints. Hemophilic arthropathy is marked by chronic pain, periarticular muscle atrophy, restricted range of motion, and proprioception issues.
This study aimed to assess the effectiveness of manual fascial therapy on joint bleeding in patients with hemophilic arthropathy. It was a randomized multicenter study, with the primary goal of evaluating the frequency of joint bleeding reported by the patients themselves. Secondary objectives included assessing muscle pain according to the visual analog scale (VAS) both during exertion and at rest. The state of the joints was evaluated using the HJHS (Haemophilia Joint Health Score). These objectives were analyzed at the study's commencement (T0), post-treatment (T1), and five months later (T2).
The experimental group (n = 33) underwent fascial therapy once a week for three weeks. The control group (n = 32) received no specific rehabilitative treatment.
Results
The reduction in the frequency of joint bleeding was significantly greater in the experimental group compared to the control group (T0: average 1.56 vs. 1.70; T1: average 0.00 vs. 0.05; T2: 0.27 vs. 0.58).
The average improvement in joint condition according to the HJHS was 1.74 points in the experimental group, whereas the control group saw a mean deterioration of 0.43 points.
Similarly, there was a reduction in pain during exertion (and to a lesser extent, pain at rest) in the experimental group. In contrast, there was no change in pain levels in the control group.
Conclusion
The authors conclude that physiotherapy involving fascial therapy appears to be safe for patients with hemophilic arthropathy and does not lead to muscle bleeding. On the contrary, it may have the potential to reduce bleeding frequency, improve overall joint condition, and alleviate joint pain.
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Source: Donoso-Úbeda E., Merono-Gallut J., López-Pina J. A., Cuesta-Barriuso R. Effect of manual therapy in patients with hemophilia and ankle arthropathy: a randomized clinical trial. Clin Rehabil 2020 Jan; 34 (1): 111–119, doi: 10.1177/0269215519879212.
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