Emma Scaddan1,2,3, John Rowell3, Shaun O'Leary1,4. 1. Physiotherapy Department, Royal Brisbane and Women's Hospital, Queensland Health, Brisbane, Australia. 2. Physiotherapy Department, Curtin University, Perth, Australia. 3. Queensland Haemophilia Centre, Royal Brisbane and Women's Hospital, Queensland Health, Brisbane, Australia. 4. NHMRC CCRE (Spinal Pain, Injury and Health), SHRS, University of Queensland, Brisbane, Australia.
Abstract
OBJECTIVES: Arthritis resulting from recurrent intra-articular bleeding in individuals with hemophilia can be severely debilitating due to joint pain and stiffness with subsequent loss of mobility and function. Very limited studies have investigated the potential benefits of joint mobilization for this condition. This case series is a preliminary investigation of safety, as well as immediate and short-term clinical benefits, associated with gentle knee and ankle joint mobilization in people with hemophilic arthropathy. METHODS: A single intervention of joint mobilization was applied to the affected knees and/or ankles of 16 individuals with severe or moderate hemophilia within a public hospital setting. Adverse events, as well as immediate (pain-free passive joint range, Timed Up and Go Test with maximum pain numerical rating scale) and short-term (Lower Extremity Functional Scale) effects of the intervention were evaluated with a repeated measures ANOVA. RESULTS: There were no adverse events. An immediate significant increase was observed in pain-free passive ankle joint range of motion (p < 0.05) following the joint mobilization intervention. DISCUSSION: The findings of this case series suggest that gentle joint mobilization techniques may be safely considered as part of a multimodal management approach for hemophilic arthropathy.
OBJECTIVES:Arthritis resulting from recurrent intra-articular bleeding in individuals with hemophilia can be severely debilitating due to joint pain and stiffness with subsequent loss of mobility and function. Very limited studies have investigated the potential benefits of joint mobilization for this condition. This case series is a preliminary investigation of safety, as well as immediate and short-term clinical benefits, associated with gentle knee and ankle joint mobilization in people with hemophilic arthropathy. METHODS: A single intervention of joint mobilization was applied to the affected knees and/or ankles of 16 individuals with severe or moderate hemophilia within a public hospital setting. Adverse events, as well as immediate (pain-free passive joint range, Timed Up and Go Test with maximum pain numerical rating scale) and short-term (Lower Extremity Functional Scale) effects of the intervention were evaluated with a repeated measures ANOVA. RESULTS: There were no adverse events. An immediate significant increase was observed in pain-free passive ankle joint range of motion (p < 0.05) following the joint mobilization intervention. DISCUSSION: The findings of this case series suggest that gentle joint mobilization techniques may be safely considered as part of a multimodal management approach for hemophilic arthropathy.
Authors: Ruth Mulvany; Audrey R Zucker-Levin; Michael Jeng; Catherine Joyce; Janet Tuller; Jonathan M Rose; Marion Dugdale Journal: Phys Ther Date: 2010-03-04