Influence of physiotherapeutic treatment on the functional independence of people with hemophilia submitted to radioactive sinovectomy
DOI:
https://doi.org/10.11606/issn.2317-0190.v30i3a181719Keywords:
Hemophilia A, Blood Coagulation Disorders, Synovectomy, Physical Therapy Specialty, RehabilitationAbstract
Radioactive synovectomy (RS) is considered the treatment of choice in the control of chronic synovitis resistant to conservative treatment, and physiotherapy is recommended to improve functionality after procedure. Objective: The aim was to verify the effects of physiotherapy on functional independence and joint health after RS. Method: This is a descriptive, retrospective, analytical study with qualitative/quantitative methodology. Physiotherapeutic evaluation, Hemophilia Joint Health Score (HJHS) application for joint outcome assessment and Functional Independence Score in Hemophilia (FISH) were used to measure the patient’s functional ability. The participants were divided into two groups: one group underwent a physiotherapy program and one not treated with physiotherapy after RS. Results: The study included 8 people with hemophilia A, all male, their mean age was 19±5.3 years. Twelve joints were submitted to RS, in which 41.67% elbows, 33.33% knees and 25% ankles. In the comparison of the groups, there was no statistically significant difference between them in joint health and functional independence. Conclusion: The study is a first attempt to describe the impact of physiotherapy on functional independence and joint health of hemophilic patients submitted to SR. Although this study has limitations, it was possible to observe that the group not treated with physiotherapy had better joint health and better functional independence prior to SR compared to the group that underwent physiotherapy, but the group treated with physiotherapy had worse overall health and have their functionality impacted by joints other than those treated with RS, presenting a higher number of target joints.
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Atilla B, Güney-Deniz H. Musculoskeletal treatment in haemophilia. EFORT Open Rev. 2019;4(6):230-239. Doi: https://doi.org/10.1302/2058-5241.4.180068
García-Chávez J, Majluf-Cruz A. Hemofilia. Gac Med Mex. 2013;149(3):308-21.
Brasil. Ministério da Saúde. Hemofilia: conheça doença que afeta quase exclusivamente homens [texto na Internet]. Brasília: Ministério da Saúde; c2020 [citado 2021 Jan 18]. Disponível em: https://www.gov.br/saude/pt-br/assuntos/noticias/2020/janeiro/hemofilia-conheca-doenca-que-afeta-quase-exclusivamente-homens
Jorge MSG, Moreira IS, Felimberti G, Wibelinger LM. Abordagem fisioterápica na dor e na qualidade de vida de um indivíduo com artrite hemofílica. Relato de caso. Rev Dor. 2016;17(1):65-8. Doi: https://doi.org/10.5935/1806-0013.20160016
Cuesta-Barriuso R. Effectiveness of physiotherapy in the treatment of hemophilic arthropathy a systematic review. Ann Hematol Oncol. 2017; 4(9):1172.
Querol-Giner M, Pérez-Alenda S, Aguilar-Rodríguez M, Carrasco JJ, Bonanad S, Querol F. Effect of radiosynoviorthesis on the progression of arthropathy and haemarthrosis reduction in haemophilic patients. Haemophilia. 2017;23(6):e497-e503. Doi: https://doi.org/10.1111/hae.13326
van Vulpen LFD, Thomas S, Keny SA, Mohanty SS. Synovitis and synovectomy in haemophilia. Haemophilia. 2021;27 Suppl 3(Suppl 3):96-102. Doi: https://doi.org/10.1111/hae.14025
Faracoa F, Uribeb A, Torob A, Lópezc J, Faracod M, Gómez Barrerae M. Efectos clínicos y funcionales de la radiosino-viortesis en pacientes con sinovitis crónica hemofílica. Un estudio prospectivo. Nivel de Evidencia: IV. Rev Colomb Ortop Traumatol. 2015;29(3):95-100. Doi: https://doi.org/10.1016/j.rccot.2016.02.006
Hashem F, Bladen M, Carroll L, Dodd C, Drechsler WI, Lowery D, et al. Protocol for a feasibility randomised controlled trial of a musculoskeletal exercise intervention versus usual care for children with haemophilia. BMJ Open. 2019;9(8):e029474. Doi: https://doi.org/10.1136/bmjopen-2019-029474
Querol F, Rodriguez-Merchan EC, Aznar JA, Lopez-Cabarcos C, Villar A. Post-synoviorthesis rehabilitation in haemophilia. Haemophilia. 2001;7 Suppl 2:54-8. Doi: https://doi.org/10.1046/j.1365-2516.2001.00111.x
Thomas S, Mendes JD, Souza SA, Lorenzato CS, Assi PE, Pacheco LR, et al. Radioactive synovectomy with (90) yttrium and (153) samarium hydroxyapatite in haemophilic joints: preliminary study on radiation safety. Haemophilia. 2013;19(4):632-6. Doi: https://doi.org/10.1111/hae.12122
Thomas S, Gabriel MB, Assi PE, Barboza M, Perri ML, Land MG, et al. Radioactive synovectomy with Yttrium⁹⁰ citrate in haemophilic synovitis: Brazilian experience. Haemophilia. 2011;17(1):e211-6. Doi: https://doi.org/10.1111/j.1365-2516.2010.02379.x
Alioglu B, Ozsoy H, Koca G, Sakaogullari A, Selver B, Ozdemir M, et al. The effectiveness of radioisotope synovectomy for chronic synovitis in Turkish paediatric haemophiliacs: Ankara experience. Haemophilia. 2010;16(6):932-6. Doi: https://doi.org/10.1111/j.1365-2516.2010.02276.x
Tena-Sanabria ME, Rojas-Sato YF, Castañeda-Resendiz JC, Fuentes-Herrera G, Álvarez-Martínez FA, Tena-Gonzalez YI, et al. Treatment with radiosynoviorthesis in hemophilic patients with and without inhibitor. BMC Pediatr. 2020;20(1):173. Doi: https://doi.org/10.1186/s12887-020-02071-3
Schäfer GS, Valderramas S, Gomes AR, Budib MB, Wolff ÁL, Ramos AA. Physical exercise, pain and musculoskeletal function in patients with haemophilia: a systematic review. Haemophilia. 2016;22(3):e119-29. Doi: https://doi.org/10.1111/hae.12909
Rodriguez-Merchan EC, De la Corte-Rodriguez H, Jimenez-Yuste V. Radiosynovectomy in haemophilia: long-term results of 500 procedures performed in a 38-year period. Thromb Res. 2014;134(5):985-90. Doi: https://doi.org/10.1016/j.thromres.2014.08.023
Vinholte Júnior NS, Vieira WHB. Meios físicos na reabilitação do paciente portador de hemofilia – uma revisão de literatura. Rev UNI-RN. 2014;9(1/2):197.
Sunny SS, Hephzibah J, Shanthly N, Oommen R, Mathew D, Abraham A. Yttrium-90 synovectomy in hemophilic arthropathy: an institutional experience for 15 years. Indian J Nucl Med. 2020;35(2):143-146. Doi: https://doi.org/10.4103/ijnm.IJNM_141_19
Magalhães AF, Oliveira LCO, Pitella FA, Wichert-Ana L, Engel EE, Barbieri CH. Yttrium-90 radiosynovectomy in knees and ankles (25 joints in 22 hemophilic patients). Short-term results. Hematol Transfus Cell Ther. 202;43(1):15-20. Doi: https://doi.org/10.1016/j.htct.2019.11.001
Wagner B, Seuser A, Krüger S, Herzig ML, Hilberg T, Ay C, et al. Establishing an online physical exercise program for people with hemophilia. Wien Klin Wochenschr. 2019;131(21-22):558-566. Doi: https://doi.org/10.1007/s00508-019-01548-1
Haje DDP, Ulisses J, Calegaro M, Machado J, Santa J, Almeida De C, et al. Sinovectomia com samário-hidroxiapatita nos tornozelos e cotovelos de hemofílicos. Rev ABTPé. 2011; 5(1): 28-35.
Galatti LR, Luiza M, Alves T, Duarte E. Exercício físico e hemofilia: conceitos e intervenção. Rev Mackenzie Educ Fís Esporte. 2012;11(2):96-109.
Groen W, van der Net J, Bos K, Abad A, Bergstrom BM, Blanchette VS, et al. Joint health and functional ability in children with haemophilia who receive intensive replacement therapy. Haemophilia. 2011;17(5):783-90. Doi: https://doi.org/10.1111/j.1365-2516.2011.02606.x
Rampersad AG, Shapiro AD, Rodriguez-Merchan EC, Maahs JA, Akins S, Jimenez-Yuste V. Radiosynovectomy: review of the literature and report from two haemophilia treatment centers. Blood Coagul Fibrinolysis. 2013;24(5):465-70. Doi: https://doi.org/10.1097/MBC.0b013e3283602a28
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