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Self-myofascial Release With Foam Roller in Patients With Hemophilic Ankle Arthropathy

1. september 2021 oppdatert av: Investigación en Hemofilia y Fisioterapia

Prospective and Multicenter Study to Assess the Safety and Effectiveness of a Physiotherapy Treatment Through Self-myofascial Release With Foam Roller in Patients With Hemophilic Ankle Arthropathy. A Randomized Clinical Trial.

Introduction: Hemophilic ankle arthropathy is manifested by degenerative functional alterations (deficit of muscle strength, mobility and proprioception) (intra-articular alterations) and chronic pain. Myofascial release techniques are used to treat soft tissue adhesions, relieve pain and reduce tissue sensitivity.

Design. A randomized clinical trial. Aimed: To evaluate the safety and effectiveness of a protocol by self-myofascial release with Foam Roller applied in patients with hemophilic ankle arthropathy.

Patients: 70 patients with ankle arthropathy will be recruited for inclusion in the study. Patients will be recruited in 5 centers, from different regions of Spain.

Intervention: Each session will last approximately 15 minutes, with five physiotherapy sessions per week for a period of 3 months. Patients will be evaluated at baseline, after the intervention, and after a follow-up period of 3 months. The treatment program includes 11 exercises that must be administered bilaterally. A mobile application will be developed where each patient will be able to observe the exercises to be carried out.

Measuring instruments and study variables: digital goniometer (ankle range of motion); visual analog scale and pressure algometer (joint pain); Haemophilia Joint Health Score (joint status); dynamometer assess (muscle strength); 6-Minute Walking test (functionality of lower limbs); Mobile device (Activity record); Finger-floor test (muscle flexibility). At the same time, the study will allow to determine joint bleeding caused by applied physiotherapy treatment.

Expected results: To demonstrate the safety of this Physiotherapy technique in patients with hemophilia. Likewise, an improvement in ankle pain, functionality and joint motion is expected.

Studieoversikt

Status

Fullført

Forhold

Intervensjon / Behandling

Studietype

Intervensjonell

Registrering (Faktiske)

58

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

    • Comunity Of Madrid
      • Madrid, Comunity Of Madrid, Spania, 28670
        • Universidad Europea de Madrid

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år til 65 år (Voksen, Eldre voksen)

Tar imot friske frivillige

Ja

Kjønn som er kvalifisert for studier

Mann

Beskrivelse

Inclusion Criteria:

  • Patients diagnosed with hemophilia A and B disease.
  • Over 18 years.
  • Diagnosed with hemophilic arthropathy of the ankle (by clinical assessment with the Hemophilia Joint Health Score).
  • On prophylactic or on demand treatment with FVIII / FIX concentrates.

Exclusion Criteria:

  • Patients without ambulation ability.
  • Patients with inhibitors (antibodies to FVIII or FIX).
  • Patients with neurological or cognitive alterations that impede the comprehension of the questionnaires and physical tests.
  • Not signed the informed consent document.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Enkelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Selvmyofascial utgivelse
Hver økt vil vare i omtrent 15 minutter, med fem fysioterapiøkter over en periode på 3 måneder. Self-Myofascial release-protokollen for underekstremitetene ved bruk av Foam Roller og Solid Ball Massasje, tilpasset pasienter med hemofil ankelartropati, vil inkludere 11 øvelser som må administreres bilateralt. Det skal utvikles en mobilapplikasjon der hver pasient skal kunne observere øvelsene som skal gjennomføres.
The Self-Myofascial release protocol for the lower limbs using a Foam Roller will include: Self-Myofascial release of the plantar region using and Solid Ball Massage; release of the myofascial components of the back of the leg using a Foam Roller; release of the myofascial components of the anterior part of the leg using a Foam Roller; release of myofascial components of the hamstring region using a Foam Roller; release of the myofascial components of the adductor muscles using a Solid Ball Massage in a sitting position; release of the myofascial components of the abductor muscles using a Foam Roller in lateral decubitus; and release of the myofascial components of the pelvitrochanteric muscles using a Foam Roller in a sitting position.
Ingen inngripen: Control
Patients included in the control group will not receive any physiotherapy intervention. They will continue with their routine prior to the beginning of the study.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change from baseline ankle joint pain after treatment and at 3 months
Tidsramme: Screening visit, within the first seven days after treatment and after three months follow-up visit
Visual analogic scale (VAS). This scale will be used to evaluate the perception of joint pain, where ankle joint pain ranges from 0 to 10 points (no pain to maximum perceived pain).
Screening visit, within the first seven days after treatment and after three months follow-up visit

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change from baseline ankle joint pain after treatment and at 3 months
Tidsramme: Screening visit, within the first seven days after treatment and after three months follow-up visit
Pressure algometer. Measuring instrument used to evaluate pressure joint pain. The instrument shall consist of a measuring device attached to a hard rubber tip 1.1 cm in diameter. Its sphere shall be calibrated in kg/cm2 with divisions of 0.1 kg/cm2. The pressure algometry methodology applied was based mainly on the study by Hogeweg. Before taking the measurements, patients will be instructed to say "yes" as soon as pressure exerted by the algometer becomes slightly unpleasant. The pressure algometer shall be kept perpendicular to the surface of the skin with the right hand, stabilizing the axis of the instrument using the thumb and index finger of the left hand. The pressure shall be increased at a uniform rate of approximately 1 kg/cm2 per second. As soon as the subject, according to the instructions, says "yes", the pressure will be stopped and the score will be noted.
Screening visit, within the first seven days after treatment and after three months follow-up visit
Change from baseline lower limb functionality after treatment and at 3 months
Tidsramme: Screening visit, within the first seven days after treatment and after three months follow-up visit
Hemophilia Joint Health Score (HJHS). This measuring instrument will be used to evaluate the joint condition of knees, ankles, and elbows. It includes 8 items (inflammation and its duration, pain, atrophy and muscle strength, crepitus, and reduced flexion and extension) ranging from 0 to 20 points per joint (the higher the score, the greater the joint deterioration).
Screening visit, within the first seven days after treatment and after three months follow-up visit
Change from baseline range of motion of ankle after treatment and at 3 months
Tidsramme: Screening visit, within the first seven days after treatment and after three months follow-up visit
Digital Goniometry Ankle ROM shall be measured using a digital goniometer. The assessment can be made with the patient standing. This measuring instrument allows more accurate measurements than those obtained with a universal plastic goniometer.
Screening visit, within the first seven days after treatment and after three months follow-up visit
Change from baseline muscle strength after treatment and at 3 months
Tidsramme: Screening visit, within the first seven days after treatment and after three months follow-up visit
Dynamometry. The maximum isometric strength of the flexor and extensor muscles of the main joints affected in hemophilia (knees and ankles) will be evaluated on both limbs with a manual dynamometer using a mark test. For this test, the rater needs to keep the dynamometer stationary while the patient exerts maximum force against it.
Screening visit, within the first seven days after treatment and after three months follow-up visit
Change from baseline muscle flexibility after treatment and at 3 months
Tidsramme: Screening visit, within the first seven days after treatment and after three months follow-up visit
Fingertip-to-Floor Test. This test is used to assess the degree of flexibility of the posterior muscles of the lower limbs. This value is calculated as the distance between the fingertip and the floor when maximum hip flexion with knee extension is performed.
Screening visit, within the first seven days after treatment and after three months follow-up visit

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Studierekorddatoer

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Studer hoveddatoer

Studiestart (Faktiske)

2. februar 2020

Primær fullføring (Faktiske)

26. juni 2020

Studiet fullført (Faktiske)

15. desember 2020

Datoer for studieregistrering

Først innsendt

11. april 2019

Først innsendt som oppfylte QC-kriteriene

11. april 2019

Først lagt ut (Faktiske)

16. april 2019

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

2. september 2021

Siste oppdatering sendt inn som oppfylte QC-kriteriene

1. september 2021

Sist bekreftet

1. september 2021

Mer informasjon

Begreper knyttet til denne studien

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • He-Foam

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