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Manual therapy in the treatment of patients with hemophilia B and inhibitor

BACKGROUND: The main clinical manifestations of hemophilia are muscle and joint bleeding. Recurrent bleeding leads to a degenerative process known as hemophilic arthropathy. The development of inhibitors (antibodies against FVIII/FIX concentrates) is the main complication in the treatment of hemophi...

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Autores principales: Cuesta-Barriuso, Rubén, Trelles-Martínez, Roberto O.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5778692/
https://www.ncbi.nlm.nih.gov/pubmed/29357868
http://dx.doi.org/10.1186/s12891-018-1934-9
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author Cuesta-Barriuso, Rubén
Trelles-Martínez, Roberto O.
author_facet Cuesta-Barriuso, Rubén
Trelles-Martínez, Roberto O.
author_sort Cuesta-Barriuso, Rubén
collection PubMed
description BACKGROUND: The main clinical manifestations of hemophilia are muscle and joint bleeding. Recurrent bleeding leads to a degenerative process known as hemophilic arthropathy. The development of inhibitors (antibodies against FVIII/FIX concentrates) is the main complication in the treatment of hemophilia. The objective was to assess the safety and efficacy of manual therapy treatment in a patient with hemophilia and inhibitor. CASE PRESENTATION: A 26-year-old patient with hemophilia B and inhibitor received physiotherapy treatment based on manual therapy for 3 months, with a frequency of 2 sessions per week. The joint status was evaluated using the Hemophilia Joint Health Score; pain was assessed with the Visual Analog Scale; and the range of movement was evaluated using a universal goniometer. The patient developed no joint bleeding in the knees or ankles as a result of the physiotherapy treatment. Following treatment, improvements were noted in the range of movement of knees and ankles, the perception of pain in both knees, and ankle functionality. CONCLUSIONS: Until now, manual therapy using joint traction was contraindicated in patients with hemophilia and inhibitor, as it was feared to cause possible joint bleeding. This is the first case study to address the safety and efficacy of manual therapy in a patient with hemophilia and an inhibitor. The results of this study may help to establish which manual therapy treatments are indicated in patients with hemophilic arthropathy and inhibitors. Thus, a physiotherapy program based on manual therapy may be safe in patients with hemophilia and inhibitor and such therapy may improve joint condition, pain, and joint range of motion in patients with hemophilia and inhibitor. Randomized clinical trials are needed to confirm the results of this case study.
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spelling pubmed-57786922018-01-31 Manual therapy in the treatment of patients with hemophilia B and inhibitor Cuesta-Barriuso, Rubén Trelles-Martínez, Roberto O. BMC Musculoskelet Disord Case Report BACKGROUND: The main clinical manifestations of hemophilia are muscle and joint bleeding. Recurrent bleeding leads to a degenerative process known as hemophilic arthropathy. The development of inhibitors (antibodies against FVIII/FIX concentrates) is the main complication in the treatment of hemophilia. The objective was to assess the safety and efficacy of manual therapy treatment in a patient with hemophilia and inhibitor. CASE PRESENTATION: A 26-year-old patient with hemophilia B and inhibitor received physiotherapy treatment based on manual therapy for 3 months, with a frequency of 2 sessions per week. The joint status was evaluated using the Hemophilia Joint Health Score; pain was assessed with the Visual Analog Scale; and the range of movement was evaluated using a universal goniometer. The patient developed no joint bleeding in the knees or ankles as a result of the physiotherapy treatment. Following treatment, improvements were noted in the range of movement of knees and ankles, the perception of pain in both knees, and ankle functionality. CONCLUSIONS: Until now, manual therapy using joint traction was contraindicated in patients with hemophilia and inhibitor, as it was feared to cause possible joint bleeding. This is the first case study to address the safety and efficacy of manual therapy in a patient with hemophilia and an inhibitor. The results of this study may help to establish which manual therapy treatments are indicated in patients with hemophilic arthropathy and inhibitors. Thus, a physiotherapy program based on manual therapy may be safe in patients with hemophilia and inhibitor and such therapy may improve joint condition, pain, and joint range of motion in patients with hemophilia and inhibitor. Randomized clinical trials are needed to confirm the results of this case study. BioMed Central 2018-01-22 /pmc/articles/PMC5778692/ /pubmed/29357868 http://dx.doi.org/10.1186/s12891-018-1934-9 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Cuesta-Barriuso, Rubén
Trelles-Martínez, Roberto O.
Manual therapy in the treatment of patients with hemophilia B and inhibitor
title Manual therapy in the treatment of patients with hemophilia B and inhibitor
title_full Manual therapy in the treatment of patients with hemophilia B and inhibitor
title_fullStr Manual therapy in the treatment of patients with hemophilia B and inhibitor
title_full_unstemmed Manual therapy in the treatment of patients with hemophilia B and inhibitor
title_short Manual therapy in the treatment of patients with hemophilia B and inhibitor
title_sort manual therapy in the treatment of patients with hemophilia b and inhibitor
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5778692/
https://www.ncbi.nlm.nih.gov/pubmed/29357868
http://dx.doi.org/10.1186/s12891-018-1934-9
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