Safety and efficacy of myofascial release therapy in the treatment of patients with hemophilic ankle arthropathy. Single-blind randomized clinical trial

ABSTRACT

Background

Hemophilia is characterized by degenerative joint damage. Patients with hemophilic arthropathy present joint damage, reduced range of motion, and decreased strength and functional capacity. Myofascial release therapy aims to decrease pain and improve tissue mobility and functionality.

Objectives

To evaluate the safety and efficacy of myofascial release therapy in patients with hemophilic ankle arthropathy.

Method

Single-blind randomized controlled trial. Fifty-eight adult patients with hemophilia were randomly allocated to the experimental group (myofascial release therapy with foam roller) or the control group (no intervention whatsoever). The daily home protocol of myofascial release therapy for the lower limbs using a foam roller lasted eight consecutive weeks. The primary variable was the safety of myofascial release therapy (weekly telephone follow-up). The secondary variables were pain intensity (visual analog scale), range of motion (goniometer), functional capacity (2-Minute Walk Test) and muscle strength (dynamometer), at baseline and at 8 and 10 weeks.

Results

During the experimental phase, none of the patients in the experimental group developed ankle hemarthrosis. There were statistically significant changes in time*group interaction in ankle dorsal flexion (F_[1.75] = 10.72; p < .001), functional capacity (F_[1.16] = 5.24; p = .009) and gastrocnemius strength (F_[2] = 26.01; p < .001). The effect size of the changes after the intervention was medium-large in pain intensity (d = −1.77), functional capacity (d = 1.34) and gastrocnemius strength (d = 0.76).

Conclusion

Myofascial release therapy is a safe form of physical therapy for patients with hemophilia. Myofascial release therapy can effectively complement prophylactic pharmacological treatment in patients with hemophilic arthropathy, improving range of motion in dorsal flexion, functional capacity and gastrocnemius strength.

KEYWORDS:

• Hemophilia
• ankle
• myofascial release therapy
• physical therapy modalities
• randomized clinical trials

Acknowledgments

We are grateful to Spanish Federation of Hemophilia, Galician Association of Hemophilia, Malaga Association of Hemophilia, Association of Hemophilia of Aragón-La Rioja, Association of Hemophilia of Valladolid-Palencia, Murcia Regional Association of Hemophilia for their help in recruiting the sample. The authors are especially grateful to the Spanish Federation of Hemophilia, Galician Association of Hemophilia, Malaga Association of Hemophilia, Association of Hemophilia of Aragón-La Rioja, Association of Hemophilia of Valladolid-Palencia, Murcia Regional Association of Hemophilia for their help in recruiting the sample.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was partially funded by Baxalta GmbH, now part of Takeda group of companies, Lexington, MA, USA [Grant ID Number: IIR-ES-002614].