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Boccalandro EA, Begnozzi V, Garofalo S, Pasca S, Peyvandi F. The evolution of physiotherapy in the multidisciplinary management of persons with haemophilia (PWH): A scoping review. Haemophilia 2023; 29:11-20. [PMID: 36167324 PMCID: PMC10086794 DOI: 10.1111/hae.14661] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 08/25/2022] [Accepted: 08/30/2022] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Haemophilia is a rare congenital bleeding disorder, and the most common manifestation is spontaneous bleeding in muscles and joints. Despite the benefits linked to recent and dramatic pharmacological advances at least in high income setting, many patients still develop musculoskeletal dysfunctions during their lifetime, which must be managed by physiotherapists in the frame of a multidisciplinary team. The aim of the scoping review is to map the available evidence by providing an overview on the past and present physiotherapy scenario in persons with haemophilia (PWH). MATERIALS AND METHODS The review was conducted according to the guidelines of the PRISMA extension for scoping reviews. Scientific articles on physiotherapy and sport interventions for PWH published from 1960 up to September 2021 have been included. Search was conducted on the e-databases PubMed and PEDro without restrictions for the study design. RESULTS Sixty eight articles were included, 52 related to rehabilitation and preventive physiotherapy, 16 to sport. The results have been reported in chronological order and divided into two categories: (1) rehabilitation and preventive physiotherapy; (2) sport activities. CONCLUSIONS This is the first scoping review on physiotherapy in haemophilia, based on the existing evidence on this topic which allowed us to underline how the role of the physiotherapist changed over time. Historically this specialist did intervene only after an acute bleed or surgical operation, but now he has a pivotal role in the multidisciplinary team that acts to improve from birth the quality of life of the PWH. His activity is also closely intertwined with sport promotion and supervision.
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Affiliation(s)
- Elena A Boccalandro
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center and Fondazione Luigi Villa, Milan, Italy
| | - Valentina Begnozzi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center and Fondazione Luigi Villa, Milan, Italy
| | - Sofia Garofalo
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center and Fondazione Luigi Villa, Milan, Italy
| | - Samantha Pasca
- Padua University Hospital, Biomedical Sciences Department (DSB), Padua, Italy.,Padua University Hospital, Medicine Department (DIMED), Padua, Italy
| | - Flora Peyvandi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center and Fondazione Luigi Villa, Milan, Italy.,Università degli Studi di Milano, Department of Pathophysiology and Transplantation, Milan, Italy
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Monoli C, Tuhtan JA, Piccinini L, Galli M. Wearable technologies for monitoring aquatic exercises: A systematic review. Clin Rehabil 2022; 37:791-807. [PMID: 36437591 PMCID: PMC10126456 DOI: 10.1177/02692155221141039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Objective To review methods for aquatic exercise monitoring using wearables. Data sources Database search of PubMed, IEEEXplore, Scopus and Web of Science based on keywords, considering articles from the year 2000. The last search was performed on 26 October 2022. Review methods Following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) protocol, eligible articles on water exercises were selected and summarized. Further screening process concentrated on studies exploiting wearable devices, organized according to demographics, purpose, protocols, outcomes and methods. A custom critical appraisal questionnaire was applied. Results Out of the 1062 articles identified, 572 were considered eligible and subjected to preliminary synthesis. The final review focused on 27 articles featuring wearable devices applied to aquatic exercises. Four studies were disregarded as they applied wearable devices to determine daily physical activity or for sleep monitoring after training. Summary tables of 23 studies exploiting wearable devices for underwater motion analysis are provided, specifying the investigated parameters, major outcomes and study quality. This review identified four research gaps: (a) the absence of clinical protocols for underwater motion studies, (b) a deficit of whole-body studies, (c) the lack of longitudinal studies monitored via wearable devices and (d) the reliance of underwater studies on measurement and assessment methods developed for land-based investigations. Conclusions This review emphasizes the need for both technological and methodological improvements for underwater motion analysis studies using wearables. We advocate for longitudinal clinical investigations with wearables to substantiate water exercise as an addition or replacement for land-based physical activity.
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Affiliation(s)
- Cecilia Monoli
- Department of Computer System, Tallinn University of Technology, Tallinn, Estonia
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | - Jeffrey A Tuhtan
- Department of Computer System, Tallinn University of Technology, Tallinn, Estonia
| | - Luigi Piccinini
- Scientific Institute “E. Medea” Ass. La Nostra Famiglia, Bosisio Parini, Italy
| | - Manuela Galli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
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Gu X, Zeng M, Cui Y, Fu J, Li Y, Yao Y, Shen F, Sun Y, Wang Z, Deng D. Aquatic strength training improves postural stability and walking function in stroke patients. Physiother Theory Pract 2022:1-10. [PMID: 35285397 DOI: 10.1080/09593985.2022.2049939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Xudong Gu
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Jiaxing University, the Second Hospital of Jiaxing City, Jiaxing City, ZJ, China
| | - Ming Zeng
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Jiaxing University, the Second Hospital of Jiaxing City, Jiaxing City, ZJ, China
| | - Yao Cui
- Department of Physical Therapy, Beijing Bo’ai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Jianming Fu
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Jiaxing University, the Second Hospital of Jiaxing City, Jiaxing City, ZJ, China
| | - Yan Li
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Jiaxing University, the Second Hospital of Jiaxing City, Jiaxing City, ZJ, China
| | - Yunhai Yao
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Jiaxing University, the Second Hospital of Jiaxing City, Jiaxing City, ZJ, China
| | - Fang Shen
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Jiaxing University, the Second Hospital of Jiaxing City, Jiaxing City, ZJ, China
| | - Ya Sun
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Jiaxing University, the Second Hospital of Jiaxing City, Jiaxing City, ZJ, China
| | - Zhongli Wang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Jiaxing University, the Second Hospital of Jiaxing City, Jiaxing City, ZJ, China
| | - Dingyi Deng
- Department of Rehabilitation, Qianjiang Central Hospital, Qianjiang City Hubei Province, China
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Feldberg G, Ricciardi JBS, Zorzi AR, Colella MP, Ozelo MC. Aquatic exercise in patients with haemophilia: Electromyographic and functional results from a prospective cohort study. Haemophilia 2021; 27:e221-e229. [PMID: 33595163 DOI: 10.1111/hae.14275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 12/21/2020] [Accepted: 02/01/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Recurrent joint bleeds in haemophilia patients often cause musculoskeletal changes leading to functional capacity impairment. AIM In this study, we assessed the effects of aquatic activities performed to improve functional capacity in these patients. METHODS The interventional protocol consisted of 24 hydrotherapy sessions during three months, in comparison with 24 swimming sessions. The pre- and post-intervention assessment consisted of Functional Independence Score, haemophilia joint health score (HJHS), Pediatric Haemophilia Activities List (PedHAL), surface electromyography (SEMG) of thigh muscles to assess muscle electric activity, and load cell on extensor and flexor thigh muscles to evaluate muscular strength. RESULTS Forty-seven haemophilia patients were enrolled in this study, and 32 (23 severe haemophilia A, one moderate haemophilia A and 8 severe haemophilia B), median age 12y (6 to 40y), concluded the aquatic intervention. We observed a statistically significant increase with substantial improvement in functional capacity in the pre- and post-intervention evaluation of hydrotherapy in comparison with the swimming protocol, with HJHS (p = .006 and p = .001 respectively), PedHAL (Sum score) (p = .022 and p = .001) and score FISH (p = .021). The swimming group revealed significant improvements in muscular strength, in all muscles tested (p = .005 and p = .001). SEMG signal amplitude reached significantly higher levels in all muscles evaluated after both interventions except for the vastus medialis (right) in the hydrotherapy group. CONCLUSION Our results concluded that both swimming and hydrotherapy were associated with physical improvement in haemophilia patients; however, only hydrotherapy lead to a more significant improvement in functional capacity.
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Affiliation(s)
- Glenda Feldberg
- Haemophilia Treatment Center (HTC) 'Cláudio Luiz Pizzigatti Corrêa', Hemocentro UNICAMP, University of Campinas, Campinas, Brazil.,Department of Internal Medicine, School of Medical Sciences, University of Campinas, UNICAMP, Campinas, Brazil
| | - Janaína B S Ricciardi
- Haemophilia Treatment Center (HTC) 'Cláudio Luiz Pizzigatti Corrêa', Hemocentro UNICAMP, University of Campinas, Campinas, Brazil.,Department of Internal Medicine, School of Medical Sciences, University of Campinas, UNICAMP, Campinas, Brazil
| | - Alessandro R Zorzi
- Department of Orthopedic and Traumatology, School of Medical Sciences, University of Campinas, UNICAMP, Campinas, Brazil
| | - Marina P Colella
- Haemophilia Treatment Center (HTC) 'Cláudio Luiz Pizzigatti Corrêa', Hemocentro UNICAMP, University of Campinas, Campinas, Brazil
| | - Margareth C Ozelo
- Haemophilia Treatment Center (HTC) 'Cláudio Luiz Pizzigatti Corrêa', Hemocentro UNICAMP, University of Campinas, Campinas, Brazil.,Department of Internal Medicine, School of Medical Sciences, University of Campinas, UNICAMP, Campinas, Brazil
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Rodriguez-Merchan EC, De la Corte-Rodriguez H. Complications of hemophilia in the elbow: current management. Expert Rev Hematol 2020; 13:991-1001. [PMID: 32723183 DOI: 10.1080/17474086.2020.1803061] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
INTRODUCTION After the ankle and knee, the elbow is the most commonly impaired joint in patients with hemophilia. AREAS COVERED A Cochrane Library and PubMed (MEDLINE) search related to elbow problems in hemophilia was conducted. Early and continuous primary hematological prophylaxis (ideally starting in infancy) is essential, given that the juvenile elbow is highly prone to the musculoskeletal complications of hemophilia. If primary hematological prophylaxis is not administered (due either to lack of affordability or lack of venous access), persistent hemarthrosis can occur in the elbow. Hemarthroses will then require aggressive treatment (through arthrocentesis under factor factor coverage) to prevent progression to synovitis (requiring prompt radiosynovectomy or arthroscopic synovectomy) and ultimately hemophilic arthropathy (requiring rehabilitation and orthopedic surgery). Between the second and fourth decade of life, many patients with hemophilia present elbow joint destruction. EXPERT OPINION In the initial stage of joint destruction, rehabilitation and intraarticular injections of hyaluronic acid can relieve the symptoms. In the advanced stage of hemophilic arthropathy, however, surgery is necessary. The main surgical procedures currently available are arthroscopic debridement, radial head resection, and total elbow arthroplasty. Transposition of the ulnar nerve and removal of heterotopic ossifications might also be necessary.
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Siqueira TC, Dominski FH, Andrade A. Effects of exercise in people with haemophilia: An umbrella review of systematic reviews and meta‐analyses. Haemophilia 2019; 25:928-937. [DOI: 10.1111/hae.13868] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 10/02/2019] [Accepted: 10/05/2019] [Indexed: 12/16/2022]
Affiliation(s)
- Thais Cristina Siqueira
- Laboratory of Sport and Exercise Psychology (Lape) of the Santa Catarina State University (Udesc) Florianópolis Brazil
| | - Fábio Hech Dominski
- Laboratory of Sport and Exercise Psychology (Lape) of the Santa Catarina State University (Udesc) Florianópolis Brazil
- Univille University Joinville Brazil
| | - Alexandro Andrade
- Laboratory of Sport and Exercise Psychology (Lape) of the Santa Catarina State University (Udesc) Florianópolis Brazil
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Passeri EV, Martinelli M, Gatteri V, Pivetti S, Passeri C, Cigolini L, Chiari S, Zenorini A, Gaffurini P, Bernardi S, Poli I, Bissolotti L. Standard and water rehabilitation: An analysis of over 14 years' experience in patients with haemophilia or other clotting factor disorders after orthopaedic surgery. Haemophilia 2019; 25:699-707. [PMID: 30994259 DOI: 10.1111/hae.13748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 03/11/2019] [Accepted: 03/11/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION In people with haemophilia (PWH) with severe arthropathy, total joint replacement (TJR) can be undertaken if conservative management fails. Post-operative rehabilitation treatment is an important part of the comprehensive management of patients undergoing TJR. AIM To compare post-operative standard rehabilitation (SR) and SR plus water rehabilitation (WR) in PWH undergoing TJR. METHODS PWH who were admitted to our centre between June 2003 and December 2016 for rehabilitation after TJR were included in the study. Rehabilitation included SR (ie, manual and mechanical mobilization, scar tissue massage, light muscle strengthening exercises and walking training with and without crutches) with or without WR. WR exercises with floats of different size and volume were performed when possible. Range of motion (ROM), muscle strength, pain level, perceived health status and length of hospital stay were analysed retrospectively. RESULTS A total of 184 patients (233 rehabilitation programmes were enrolled in the study, corresponding to 160 after total knee replacement [TKR], 37 after total ankle replacement [TAR] and 36 after total hip replacement [THR]). Fifty-eight (25%) patients were treated with WR in addition to SR (32 for TKR, 19 for TAR and 7 for THR) with an average of 5.7 hours of WR. Muscle strength, pain and perceived health status improved significantly after rehabilitation. CONCLUSION This non-randomized study seems to indicate that WR plus SR improves muscle strength, pain and perceived health status more than SR alone in PWH undergoing TJR. It would be necessary, however, to carry out randomized comparative studies to confirm these provisional conclusions.
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Affiliation(s)
- E V Passeri
- Dipartimento di Riabilitazione, Fondazione T. Camplani - Casa di Cura "Domus Salutis", Brescia, Italy
| | - Marco Martinelli
- Dipartimento di Riabilitazione, Fondazione T. Camplani - Casa di Cura "Domus Salutis", Brescia, Italy
| | - Vincenzo Gatteri
- Dipartimento di Riabilitazione, Fondazione T. Camplani - Casa di Cura "Domus Salutis", Brescia, Italy
| | - Stefania Pivetti
- Dipartimento di Riabilitazione, Fondazione T. Camplani - Casa di Cura "Domus Salutis", Brescia, Italy
| | - Chiara Passeri
- School of Public Health, Università degli studi di Brescia, Brescia, Italy
| | - Luisa Cigolini
- Dipartimento di Riabilitazione, Fondazione T. Camplani - Casa di Cura "Domus Salutis", Brescia, Italy
| | - Sonia Chiari
- Dipartimento di Riabilitazione, Fondazione T. Camplani - Casa di Cura "Domus Salutis", Brescia, Italy
| | - Andrea Zenorini
- Dipartimento di Riabilitazione, Fondazione T. Camplani - Casa di Cura "Domus Salutis", Brescia, Italy
| | - Paolo Gaffurini
- Dipartimento di Riabilitazione, Fondazione T. Camplani - Casa di Cura "Domus Salutis", Brescia, Italy
| | - Stefano Bernardi
- Dipartimento di Riabilitazione, Fondazione T. Camplani - Casa di Cura "Domus Salutis", Brescia, Italy
| | - Ilaria Poli
- Dipartimento di Riabilitazione, Fondazione T. Camplani - Casa di Cura "Domus Salutis", Brescia, Italy
| | - Luciano Bissolotti
- Dipartimento di Riabilitazione, Fondazione T. Camplani - Casa di Cura "Domus Salutis", Brescia, Italy
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