From the Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Chiayi, Taiwan (C-MC, K-YK); School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan (C-MC); and Department of Physical Medicine and Rehabilitation, Lin Shin Hospital, Taichung, Taiwan (C-HL).
Am J Phys Med Rehabil. 2023 Jul 1;102(7):577-587. doi: 10.1097/PHM.0000000000002212. Epub 2023 Feb 20.
This study investigated the effects of physical therapy, including exercise, manual therapy, and physical agent modality, on joints, muscle strength, and mobility of patients with hemophilia.
PubMed, Embase, MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus were searched from inception to September 10, 2022. Randomized controlled trials comparing pain, range of motion, and health of joints, as well as muscle strength and mobility (timed up and go test) between physical therapy and control groups were included.
Fifteen randomized controlled trials with 595 male patients with hemophilia were included. In comparisons between physical therapy and control groups, physical therapy significantly reduced joint pain (standardized mean difference = -0.87; 95% confidence interval, -1.14 to -0.60), increased joint range of motion (standardized mean difference = 0.24; 95% confidence interval, 0.14-0.35), enhanced joint health (standardized mean difference = -1.08; 95% confidence interval, -1.38 to -0.78), improved muscle strength (standardized mean difference = 1.42; 95% confidence interval, 1.16-1.69), and timed up and go test performance (standardized mean difference = -1.25; 95% confidence interval, -1.89 to -0.60). The comparisons demonstrate moderate to high evidentiary quality grades.
Physical therapy is effective in reducing pain, increasing joint range of motion, enhancing joint health, as well as improving muscle strength and mobility in patients with hemophilia.
Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME.
Upon completion of this article, the reader should be able to: (1) Recognize the overall effectiveness of physical therapy for patients with hemophilia; (2) Determine how therapeutic exercise can help improve various outcomes of major joints in these patients; and (3) Appraise that physical therapy is safe and can be implemented in clinical practice for these patients.
Advanced.
The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s) ™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
本研究旨在探讨物理治疗（包括运动、手法治疗和物理因子治疗）对血友病患者关节、肌肉力量和活动度的影响。
检索 PubMed、Embase、MEDLINE、Cochrane 对照试验中心注册库、Web of Science 和 Scopus，检索时间从建库至 2022 年 9 月 10 日。纳入比较物理治疗组与对照组疼痛、关节活动度和关节健康状况以及肌肉力量和活动度（计时起立行走试验）的随机对照试验。
纳入了 15 项随机对照试验，共 595 名男性血友病患者。与对照组相比，物理治疗组显著降低了关节疼痛（标准化均数差=-0.87；95%置信区间，-1.14 至-0.60），增加了关节活动度（标准化均数差=0.24；95%置信区间，0.14-0.35），改善了关节健康（标准化均数差=-1.08；95%置信区间，-1.38 至-0.78），增强了肌肉力量（标准化均数差=1.42；95%置信区间，1.16-1.69），并缩短了计时起立行走试验的完成时间（标准化均数差=-1.25；95%置信区间，-1.89 至-0.60）。这些比较结果具有中等到高的证据质量等级。
物理治疗可有效减轻血友病患者的疼痛，增加关节活动度，改善关节健康，以及增强肌肉力量和活动度。
索取 CME 学分：请在 http://www.physiatry.org/JournalCME 上完成自我评估活动和评价。
CME 目标：完成本文后，读者应能够：（1）认识到物理治疗对血友病患者的整体有效性；（2）确定治疗性运动如何有助于改善这些患者主要关节的各种结果；（3）评估物理治疗安全且可在这些患者的临床实践中实施。
级别：高级。
认可：学术物理治疗协会经继续医学教育认证委员会认可，可为医生提供继续医学教育。学术物理治疗协会将这项基于期刊的 CME 活动最多指定为 1.0 个 AMA PRA 类别 1 学分 ™。医生应仅声称符合其参与活动程度的学分。
