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Foam roller-based self-induced myofascial therapy in patients with hemophilic knee arthropathy: a multicenter, single-blind, randomized clinical study [with consumer summary]
Donoso-Ubeda E, Perez-Llanes R, Merono-Gallut J, Ucero-Lozano R, Cuesta-Barriuso R
European Journal of Physical and Rehabilitation Medicine 2023 Dec;59(6):763-771
clinical trial
8/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

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 to -0.41) and pain intensity (MD -0.33; 95% CI -0.48 to -0.18), increased range of motion (MD 0.88; 95% CI 0.39 to 1.37), strength in quadriceps (MD 0.88; 95% CI 0.39 to 1.37). (MD 12.39; 95% CI 3.44 to 21.34) and hamstrings (MD 7.85; 95% CI 0.60 to 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.

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