OBJECTIVE: The aim of this study was to evaluate the effects of a manual therapy using fascial therapy on joint bleeding, joint pain and joint function in patients with hemophilic ankle arthropathy. SETTING: Hemophilia patient associations. DESIGN: Randomized, controlled trial, multicenter and intention-to-treat analysis. PARTICIPANTS: A total of 65 patients with hemophilic ankle arthropathy. INTERVENTION: The experimental group (n = 33) received one fascial therapy session per week for three weeks. The control group (n = 32) received no treatment. OUTCOME MEASURE: The primary outcome was frequency of joint bleeding measured using self-reporting. Secondary outcomes were joint pain (under load-bearing and non-load-bearing conditions) measured using the visual analog scale; joint condition was measured using the Hemophilia Joint Health Score. Outcomes were measured at baseline, posttreatment and after five months of follow-up. RESULTS: Improvements in the frequency joint bleeding at T0, T1 and T2 were significantly higher in the experimental group (T0 mean (SD) 1.56 (1.30); T1 mean (SD) 0.00 (0.00); T2 mean (SD) 0.27 (0.57)) compared to the control group (T0 mean (SD) 1.70 (1.78); T1 mean (SD) 0.05 (0.21); T2 mean (SD) 0.58 (0.85)). Mean improvement of joint state after the study period was 1.74 points (+/- 1.66) for patients in the experimental group, while the control group exhibited a joint deterioration with 0.43 points (+/- 0.85). Ankle joint pain under load-bearing and non-load-bearing conditions improved in the experimental group with -1.72 (+/- 1.86) and -0.50 (+/- 1.39) points, respectively. CONCLUSION: The study showed that fascial therapy is favorable for patients with hemophilic ankle arthropathy.

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