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基于泡沫轴的自我诱导的肌筋膜疗法治疗血友病性膝关节病:一项多中心、单盲、随机临床研究。

Foam roller-based self-induced myofascial therapy in patients with hemophilic knee arthropathy: a multicenter, single-blind, randomized clinical study.

机构信息

Department of Physiotherapy, UCAM Catholic University of Murcia, Murcia, Spain.

InHeFis Research Group, Instituto Asturiano de Investigación Sanitaria, Oviedo, Spain.

出版信息

Eur J Phys Rehabil Med. 2023 Dec;59(6):763-771. doi: 10.23736/S1973-9087.23.07944-3. Epub 2023 Oct 23.

Abstract

BACKGROUND

Hemophilia is a congenital coagulopathy characterized by degenerative joint damage. Self-induced myofascial therapy aims to decrease pain and improve tissue mobility, functionality and proprioception.

AIM

The aim of this study was to evaluate the safety and efficacy of self-induced myofascial release in patients with hemophilic knee arthropathy.

DESIGN

This is a randomized clinical study.

SETTING

This study was carried out in different patient associations.

POPULATION

Fifty-two patients with hemophilia were included in the study.

METHODS

Patients were randomized to the experimental group (daily home protocol of foam roller-based self-induced myofascial therapy for 8 weeks) or the control group (no intervention). The variables were the frequency of hemarthrosis (self-reporting), pain intensity (visual analog scale), range of motion (goniometry) and muscle strength (dynamometry). All variables were evaluated at baseline, post-treatment and after a 10-week follow-up.

RESULTS

The patients included in the experimental group showed significant improvements in terms of a decrease in frequency of hemarthrosis (mean difference [MD]=-0.61; 95% confidence interval [CI]: -0.81; -0.41) and pain intensity (MD=-0.33; 95% CI: -0.48, -0.18), increased range of motion (MD=0.88; 95% CI: 0.39; 1.37), strength in quadriceps (MD=0.88; 95% CI: 0.39; 1.37). (MD=12.39; 95% CI: 3.44; 21.34) and hamstrings (MD=7.85; 95% CI: 0.60; 15.11). There were intergroup differences in the frequency of hemarthrosis (F=14.51; P<0.001), pain intensity (F=9.14; P<0.001) and range of motion (F=13.58; P<0.001).

CONCLUSIONS

Self-induced myofascial therapy can be an effective complementary technique in the treatment of patients with hemophilic arthropathy. Self-induced myofascial therapy can reduce the frequency of knee hemarthrosis in patients with hemophilia. This technique can improve pain intensity and range of motion in patients with hemophilic knee arthropathy.

CLINICAL REHABILITATION IMPACT

Hemophilic knee arthropathy is characterized by chronic pain, decreased range of motion, and periarticular muscle atrophy. Foam roller-based self-induced myofascial therapy can reduce the frequency of hemarthrosis and pain intensity and improve range of motion in patients with hemophilic arthropathy. Foam roller-based self-induced myofascial therapy is safe and effective in the treatment of patients with hemophilia. The inclusion of self-induced myofascial therapy exercises in the approach to degenerative joint pathologies may be an effective and safe treatment option.

摘要

背景

血友病是一种以退行性关节损伤为特征的先天性凝血障碍。自我诱导的肌筋膜疗法旨在减轻疼痛并改善组织的活动性、功能和本体感觉。

目的

本研究旨在评估自我诱导的肌筋膜松解术在血友病性膝关节病患者中的安全性和有效性。

设计

这是一项随机临床试验。

设置

本研究在不同的患者协会中进行。

人群

纳入了 52 名血友病患者。

方法

患者被随机分为实验组(每天在家中使用泡沫轴进行自我诱导的肌筋膜疗法,持续 8 周)或对照组(无干预)。变量包括关节积血的频率(自我报告)、疼痛强度(视觉模拟量表)、活动范围(量角器)和肌肉力量(测力计)。所有变量均在基线、治疗后和 10 周随访时进行评估。

结果

实验组患者的关节积血频率显著降低(平均差异 [MD]=-0.61;95%置信区间 [CI]:-0.81;-0.41),疼痛强度(MD=-0.33;95% CI:-0.48,-0.18)、活动范围(MD=0.88;95% CI:0.39;1.37)、股四头肌(MD=0.88;95% CI:0.39;1.37)和腘绳肌(MD=12.39;95% CI:3.44;21.34)和 hamstrings(MD=7.85;95% CI:0.60;15.11)。关节积血频率(F=14.51;P<0.001)、疼痛强度(F=9.14;P<0.001)和活动范围(F=13.58;P<0.001)存在组间差异。

结论

自我诱导的肌筋膜疗法是治疗血友病性关节炎患者的一种有效补充技术。自我诱导的肌筋膜疗法可减少血友病患者膝关节积血的发生频率。这种技术可以改善血友病性膝关节关节炎患者的疼痛强度和活动范围。

临床康复影响

血友病性膝关节关节炎的特点是慢性疼痛、活动范围减小和关节周围肌肉萎缩。基于泡沫轴的自我诱导的肌筋膜疗法可减少关节积血的发生频率和疼痛强度,并改善血友病性关节炎患者的活动范围。基于泡沫轴的自我诱导的肌筋膜疗法治疗血友病患者安全有效。在退行性关节病变的治疗中纳入自我诱导的肌筋膜疗法锻炼可能是一种有效且安全的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb9e/10795767/eb90204edf76/7944-f1.jpg

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