Effectiveness of therapeutic exercise and cognitive-behavioural therapy combined protocol on functionality, pain and joint health in people with haemophilia: Secondary analysis of a controlled trial

Autores de IIS La Fe

• Maria Garcia Dasi

  Autor

• Santiago Bonanad Boix

  Autor

• Marta Aguilar Rodriguez

  Autor

Participantes ajenos a IIS La Fe

• Moreno-Segura, N.
• Pérez-Alenda, S.
• Carrasco, J.J.
• Marqués-Sulé, E.
• Querol, F.

Grupos

• Hemostasia, Trombosis, Arteriosclerosis y Biología vascular

Abstract

Background: Haemophilic arthropathy is one of the main causes of morbidity in people with haemophilia (PWH), inducing pain and reduced functionality. Therefore, PWH are complex patients and must be approached from a multidisciplinary perspective. Objectives: To evaluate the effectiveness of a therapeutic exercise and cognitive-behavioural therapy (CBT) combined protocol on functionality, pain, and joint health of PWH, arthropathy and chronic pain. Treatment satisfaction was also evaluated. Methods: A single-blinded clinical trial with 21 PWH in prophylactic regimen was carried out. Participants were divided into an experimental group (EG, n = 11) and a control group (CG, n = 10). The EG underwent a 4-month programme of home-based therapeutic exercise plus CBT, whilst CG performed their daily activities. Patients were evaluated at baseline, post-intervention and after 12 additional weeks. Measures of functionality (Haemophilia Activities List, Timed Up and Go Test, 2-Minutes-Walking-Test and Sit-to-Stand Test), pain (PainDETECT and Visual Analogue Scale) and joint health (Haemophilia Joint Health Score) were taken. Related dimensions of the A36 Haemophilia Quality of Life Questionnaire were calculated. Effects were calculated using a two-factor ANOVA. Results: The EG showed significant improvements in function (p <.001), pain (p <.001), joint damage (p =.006), and satisfaction with the treatment (p =.006) dimensions of the A36 Haemophilia Quality of Life Questionnaire, as well as in pain measured with the Visual Analogue Scale (p =.008) and PainDETECT (p =.035). Conclusions: The combined physiotherapy and CBT protocol showed a partial improvement in functionality, pain and joint health of PWH, arthropathy and chronic pain. In addition, participants were satisfied with the treatment. © 2022 John Wiley & Sons Ltd.

Keywords

• adult; analysis of variance; Article; clinical article; cognitive behavioral therapy; controlled study; daily life activity; functional status; hemophilia; home care; human; joint; kinesiotherapy; pain; patient satisfaction; quality of life; secondary analysis; sit-to-stand test; timed up and go test; visual analog scale; walk test; arthropathy; body equilibrium; chronic pain; hemophilia A; procedures; randomized controlled trial (topic); task performance; Chronic Pain; Cognitive Behavioral Therapy; Exercise Therapy; Hemophilia A; Humans; Joint Diseases; Postural Balance; Quality of Life; Randomized Controlled Trials as Topic; Time and Motion Studies