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血友病患者肌腱病的超声评估用于康复指征

Ultrasound Evaluation of Tendinopathy in Hemophiliac Patients for the Purpose of Rehabilitation Indications.

作者信息

Donati Danilo, Spinnato Paolo, Valdrè Lelia, Piscitelli Lydia, Farella Giuseppina Mariagrazia, Pagliarulo Enrico, Benedetti Maria Grazia

机构信息

Physical Therapy and Rehabilitation Unit, Policlinico di Modena, 41125 Modena, Italy.

Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41124 Modena, Italy.

出版信息

J Clin Med. 2023 Jul 6;12(13):4513. doi: 10.3390/jcm12134513.

Abstract

BACKGROUND

Hemophilia is a inherited bleeding disorder that is characterized by intra-articular bleeding (hemarthrosis). The aim of the study was to evaluate the state of the satellite tendons of the target joints in the patient with hemophilic arthropathy and propose rehabilitation treatment with eccentric exercises.

METHODS

The tendons of the joints mainly affected by hemophilic arthropathy were evaluated by ultrasound. The ultrasound evaluation is associated with the use of evaluation clinical scales, such as the Hemophilia Joint Health Score (HJHS), the Functional Independence Score in Hemophilia (FISH), the Hemophilia Activity List (HAL), the DASH, the VISA-A, the VISA-P, and the VAS scale.

RESULTS

In 20 patients with hemophilic arthropathy, the thickness of the tendons that were examined was normal. In six subjects with severe joint damage, echostructural alterations were present, and signs of hyperemia and neo-vascularization were detected on color Doppler, as well as the presence of intratendinous calcifications.

CONCLUSIONS

The tendons of the target joints in patients with hemophilic arthropathy are compromised by the indirect biomechanical damage caused by the joint disease, and rehabilitation treatment with eccentric exercises can be considered safe and effective in improving the tenso-elastic properties of the tendons.

摘要

背景

血友病是一种遗传性出血性疾病,其特征为关节内出血(关节积血)。本研究的目的是评估血友病性关节病患者目标关节的卫星肌腱状态,并提出采用离心运动的康复治疗方案。

方法

通过超声评估主要受血友病性关节病影响的关节的肌腱。超声评估与使用评估临床量表相关,如血友病关节健康评分(HJHS)、血友病功能独立性评分(FISH)、血友病活动清单(HAL)、上肢功能障碍评分量表(DASH)、血友病关节功能评分A(VISA-A)、血友病关节功能评分P(VISA-P)和视觉模拟评分量表(VAS)。

结果

在20例血友病性关节病患者中,所检查肌腱的厚度正常。在6例关节严重受损的受试者中,存在回声结构改变,彩色多普勒检测到充血和新生血管迹象,以及肌腱内钙化。

结论

血友病性关节病患者目标关节的肌腱受到关节疾病引起的间接生物力学损伤,采用离心运动的康复治疗在改善肌腱的张力弹性特性方面可被认为是安全有效的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8908/10342756/5e5fc91f0a31/jcm-12-04513-g001.jpg

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