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Vol. 28. Issue 2.
Pages 124-133 (April - June 2021)
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Vol. 28. Issue 2.
Pages 124-133 (April - June 2021)
Review Article - Meta-analysis
DOI: 10.1016/j.rcreue.2020.05.008
Physical rehabilitation of patients with hemophilic arthropathy: Systematic review and pain-related meta-analysis
Rehabilitación física en pacientes con artropatía hemofílica: revisión sistemática y metaanálisis sobre dolor
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Ana I. Pacheco-Serranoa, David Lucena-Antóna,
Corresponding author
david.lucena@uca.es

Corresponding author.
, José A. Moral-Muñoza,b
a Departamento de Enfermería y Fisioterapia, Universidad de Cádiz, Cádiz, Spain
b Instituto de Investigación e Innovación en Ciencias Biomédicas de la Provincia de Cádiz (INiBICA), Universidad de Cádiz, Cádiz, Spain
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Table 1. Search equations.
Table 2. Key characteristics of the participants.
Table 3. Characteristics of the trials included.
Table 4. Methodological assessment according to PEDro Scale.
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Abstract
Introduction

Haemophilic arthropathy presents with different important clinical disorders, such as joint disease, pain, decreased range of motion, and functional alterations that can produce limitations in functionality and mobility. The physical exercise adapted to patients with haemophilia can be an adequate therapeutic strategy, having a positive impact on the quality of life of these subjects.

Objectives

To identify the published clinical trials that evaluate the efficacy of physical rehabilitation in the treatment of haemophilic arthropathy.

Materials and methods

A systematic review and meta-analysis of clinical trials was conducted (using pre-defined eligibility criteria). The literature search was performed in the databases: PEDro, Pubmed, Scopus, and Web of Science. The quality of the methods used in the studies was evaluated using the PEDro scale.

Results

After applying the inclusion and exclusion criteria, 7 studies were included in this review, providing favourable results on muscle strength and circumference, range of motion, joint disease, and quality of life. Moreover, 2 articles contributed information to the meta-analysis, showing favourable results on pain [Standardised mean difference (SMD) = −2.64; 95% CI: (−4.26 − +1.03)].

Conclusions

This systematic review found evidence on the efficacy of physical rehabilitation in the treatment for haemophilic arthropathy. Therapeutic exercise is the main treatment carried out, obtaining significant improvements in the different physical outcomes.

Keywords:
Physical rehabilitation
Haemophilia
Arthropathy
Therapeutic exercise
Manual therapy
Haemophilic arthropathy
Joint disease
Resumen
Introducción

La artropatía hemofílica cursa con diferentes manifestaciones clínicas importantes, como son las hemorragias articulares, dolor, disminución de la amplitud de movimiento y alteraciones funcionales que pueden causar secuelas a nivel de funcionalidad y movilidad. El ejercicio físico adaptado a los pacientes con hemofilia puede ser una adecuada estrategia terapéutica, repercutiendo positivamente sobre la calidad de vida de dichos sujetos.

Objetivos

Evaluar la eficacia de la rehabilitación física en el tratamiento de la artropatía hemofílica. Materiales y métodos: Se ha realizado una revisión sistemática y meta-análisis de ensayos clínicos (seleccionados según criterios de elegibilidad). Para ello, se han utilizado las siguientes bases de datos: PEDro, Pubmed, Scopus y Web of Science. Se empleó la escala “PEDro” para evaluar la calidad metodológica de los estudios.

Resultados

Tras aplicar los criterios de inclusión y exclusión, 7 artículos fueron incluidos en la revisión final, aportando resultados favorables sobre la fuerza y diámetro muscular, rango de movilidad y estado articular, y calidad de vida. De ellos, 2 estudios aportaron datos para meta-análisis, mostrando resultados favorables sobre la variable: dolor [Diferencia de medias estandarizada (DME)=-2,64; IC95%:(-4,26;1,03)].

Conclusiones

Se encontró evidencia sobre la eficacia de la rehabilitación física en el tratamiento de la artropatía hemofílica. El ejercicio terapéutico es el principal tratamiento realizado, obteniendo mejoras significativas en distintas variables físicas.

Palabras clave:
Rehabilitación
Hemofilia
Artropatía
Ejercicio terapéutico
Terapia manual
Artropatía hemofílica
Enfermedad articular

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