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筋膜治疗对血友病性踝关节关节炎患者的功能和活动范围的影响:一项随机临床试验。

Functionality and range of motion in patients with hemophilic ankle arthropathy treated with fascial therapy. A randomized clinical trial.

机构信息

Department of Physiotherapy, European University of Madrid, Spain; Royal Victoria Eugenia Foundation, Madrid, Spain; Fishemo CEE. Spanish Federation oh Hemophilia, Madrid, Spain.

Optimus Osteopathy and Physiotherapy Clinic, Murcia, Spain.

出版信息

Musculoskelet Sci Pract. 2020 Oct;49:102194. doi: 10.1016/j.msksp.2020.102194. Epub 2020 May 23.

Abstract

BACKGROUND

Hemophilic arthropathy is characterized by loss of function and range motion. Fascial therapy mobilizes the connective tissue, intervening in the state of the injured fascial complex.

OBJECTIVES

The aim of this study is to assess the safety and effectiveness of a fascial therapy treatment in patients with hemophilic ankle arthropathy.

DESIGN

Randomized clinical trial.

METHODS

Sixty-five adult patients with hemophilia from 18 to 65 years of age were recruited. The intervention through fascial therapy lasted 3 consecutive weeks with a weekly session of 45 min each. The dependent variables were frequency of bleeding (selfregistration), ankle range of motion (goniometer) and lower limb functionality (6-Minute Walking Test). Three assess were made: baseline, posttreatment and after follow-up period. ANOVA of repeated measures was performed to compare both groups at the three assess time points. Bonferroni correction has been applied to control the error rate of the significance level.

RESULTS

Improvements were found (p < 0.001) in terms of a reduced frequency of ankle hemarthrosis. Significant differences were found in the experimental group following intervention (p < 0.001), and when comparing baseline and follow-up assessments (p < 0.05) in all variables. The frequency of hemarthrosis (p = 0.04) and functionality (p = 0.01) improved in patients who received manual therapy as compared to the control group.

CONCLUSIONS

Fascial therapy achieves improvements in terms of frequency of hemarthrosis in patients with hemophilic ankle arthropathy. Ankle functionality improved in patients treated with manual therapy. This technique can improve ankle range of motion.

摘要

背景

血友病性关节病的特征是功能丧失和活动范围减小。筋膜疗法可使结缔组织活动,干预受伤的筋膜复合体的状态。

目的

本研究旨在评估筋膜治疗对血友病性踝关节病患者的安全性和有效性。

设计

随机临床试验。

方法

招募了 65 名年龄在 18 至 65 岁之间的成年血友病患者。筋膜治疗干预持续 3 周,每周进行 1 次,每次 45 分钟。依赖变量为出血频率(自我登记)、踝关节活动范围(量角器)和下肢功能(6 分钟步行测试)。进行了 3 次评估:基线、治疗后和随访期后。采用重复测量方差分析比较两组在三个评估时间点的情况。应用 Bonferroni 校正控制显著水平的误差率。

结果

发现踝关节关节内血肿的发生频率降低(p<0.001)。干预后实验组有显著差异(p<0.001),并且在基线和随访评估时(p<0.05)所有变量均有显著差异。与对照组相比,接受手法治疗的患者的关节内血肿(p=0.04)和功能(p=0.01)频率有所改善。

结论

筋膜治疗可减少血友病性踝关节病患者关节内血肿的发生频率。接受手法治疗的患者踝关节功能得到改善。该技术可以改善踝关节活动范围。

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