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一项监督性治疗运动计划对血友病患者肌肉骨骼健康和步态的影响:一项试点研究。

Effects of a supervised therapeutic exercise program on musculoskeletal health and gait in patients with haemophilia: A pilot study.

作者信息

Deniz Volkan, Guzel Nevin Atalay, Lobet Sébastien, Antmen Ali Bülent, Sasmaz Hatice Ilgen, Kilci Abdullah, Boyraz Omer Cumhur, Gunaştı Ozgür, Kurdak Sanli Sadi

机构信息

Department of Physiotherapy and Rehabilitation, Gazi University Faculty of Health Sciences, Ankara, Turkey.

Service d'hématologie, Cliniques universitaires Saint-Luc, Bruxelles, Belgium.

出版信息

Haemophilia. 2022 Jan;28(1):166-175. doi: 10.1111/hae.14444. Epub 2021 Oct 22.

Abstract

INTRODUCTION

Episodes of bleeding in patients with haemophilia (PwH) are associated with haemophilic arthropathy, limitations in physical performance, reduced quality of life (QoL), and gait disorders.

AIM

This non-randomized, controlled, interventional, prospective, single-centre pilot study aimed to assess the effects of an 8-week supervised therapeutic exercise program on musculoskeletal health, gait kinematic parameters (GKP), functional capacity, and QoL in adult PwH.

METHODS

Nineteen PwH were allocated to an exercise group (n = 10) or a control group (n = 9). The patients in the exercise group followed an 8-week supervised therapeutic exercise program. The Haemophilia Joint Health Score (HJHS), a two-dimensional video-based gait kinematic analysis (2D-GKA), the 6-min walking test (6MWT), and the Haemophilia Quality of Life Questionnaire for Adults (Haem-A-Qol) were used as the outcome measures at baseline, after the exercise program (at the 8th week), and at the 6th-month follow-up.

RESULTS

A significant improvement was observed in the exercise group in the HJHS-Total and Haem-A-Qol Total scores and the 6MWT value after the exercise program. Moreover, the 2D-GKA revealed improvement in most of the GKP (knee extension during the midstance and late swing phases, ankle dorsiflexion during the midstance phase, and ankle plantar flexion during the preswing phase). However, the gain obtained by the exercise program was not maintained at the 6th-month follow-up for the HJHS-Total and Hem-A-QoL-Total scores and GKP.

CONCLUSION

The 8-week supervised therapeutic exercise program was successful in achieving improvement in joint health, GKP, functional capacity, and QoL in PwH.

摘要

引言

血友病患者(PwH)的出血发作与血友病性关节病、身体机能受限、生活质量(QoL)下降和步态障碍有关。

目的

这项非随机、对照、干预性、前瞻性单中心试点研究旨在评估为期8周的有监督治疗性运动计划对成年PwH肌肉骨骼健康、步态运动学参数(GKP)、功能能力和生活质量的影响。

方法

19名PwH被分配到运动组(n = 10)或对照组(n = 9)。运动组患者遵循为期8周的有监督治疗性运动计划。使用血友病关节健康评分(HJHS)、基于二维视频的步态运动学分析(2D-GKA)、6分钟步行试验(6MWT)和成人血友病生活质量问卷(Haem-A-Qol)作为基线、运动计划后(第8周)和第6个月随访时的结局指标。

结果

运动组在运动计划后HJHS总分、Haem-A-Qol总分和6MWT值方面有显著改善。此外,2D-GKA显示大多数GKP有所改善(支撑中期和摆动后期的膝关节伸展、支撑中期的踝关节背屈以及摆动前期的踝关节跖屈)。然而,运动计划所取得的改善在第6个月随访时,HJHS总分、Hem-A-QoL总分和GKP未得到维持。

结论

为期8周的有监督治疗性运动计划成功改善了PwH的关节健康、GKP、功能能力和生活质量。

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