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Fascial Therapy in Elbow Hemophilic Arthropathy (HeL-Fascial)

25 februari 2019 uppdaterad av: Rubén Cuesta-Barriuso, PhD, Real Fundación Victoria Eugenia

Prospective and Multicenter Study to Assess the Safety and Effectiveness of a Physiotherapy Treatment Through Fascial Therapy in Hemophilic Elbow Arthropathy. A Pilot Study.

Introduction: The common clinical manifestations of hemophilia are skeletal muscle bleeds, especially hematomas and hemarthrosis. Repeated episodes of joint bleeding in certain joints, causing a progressive joint deterioration. Secondary disorders to this joint degeneration include: biomechanical alterations, loss of range of movement and periarticular muscle atrophy.

Design. A prospective, multicenter and longitudinal pilot study to evaluate the efficacy of a treatment protocol with fascial therapy applied in patients with hemophilic arthropathy of the elbow.

Aimed: To evaluate the safety and efficacy of a physiotherapy treatment by fascial therapy in patients with hemophilic arthropathy of the elbow Patients: A total of 60 patients with hemophilia and prophylactic treatment will be recruited for inclusion in the study. Patients will be recruited in 6 centers, from different regions of Spain.

Intervention: Each session will last approximately 50 minutes, with three physiotherapy sessions taking place over a period of 3 weeks. The treatment program includes 11 maneuvers that must be administered bilaterally:

Measuring instruments and study variables: goniometric evaluation (range of movement); visual analog scale (joint pain); Haemophilia Joint Health Score (joint status); DASH Questionnaire (functionality of upper limbs); SF-36 Questionnaire (perception of quality of life). At the same time, the study will allow to determine joint bleeding caused by applied physiotherapy treatment.

Expected results: First, it is intended to demonstrate the safety of this physiotherapy technique in patients with hemophilia. Likewise, an improvement in the perception of elbow pain and joint mobility is expected. An improved functionality of the upper limb is also foreseen and with it, an enhanced perception of quality of life of these patients.

Studieöversikt

Status

Avslutad

Betingelser

Intervention / Behandling

Studietyp

Interventionell

Inskrivning (Faktisk)

69

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

  • Spanien
    • Madird
      • Madrid, Madird, Spanien, 28029
        • Royal Victoria Eugenia Foundation

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år till 65 år (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Manlig

Beskrivning

Inclusion Criteria:

  • Patients diagnosed with hemophilia A and B
  • Patients adults (over 18 years)
  • Patients diagnosed with hemophilic arthropathy of the elbow (by clinical assessment with the Hemophilia Joint Health Score)
  • Patients pn prophylactic treatment with FVIII / FIX concentrates.

Exclusion Criteria:

  • Patients without ambulation ability
  • Patients with inhibitors
  • Patients with neurological or cognitive alterations that impede the comprehension of the questionnaires and physical tests
  • Patients who have not signed the informed consent document.

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Crossover tilldelning
  • Maskning: Enda

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Expermiental group
All patients included in the experimental group should be on prophylactic treatment with FVIII / FIX concentrates. Likewise, the factor should be administered on the same day that they receive each of the fascial therapy treatment sessions. Each session will last approximately 50 minutes, with three physiotherapy sessions taking place over a period of 3 weeks. The treatment program includes 11 maneuvers that must be administered bilaterally:
Övrig: Experimental group

Longitudinal surface sliding maneuver over the superficial fascia in the anterior region of the arm and the forearm. Applied in 3 strokes.

  • Transverse sliding of the flexor muscles of the wrist and fingers.
  • Transverse sliding for the biceps brachii muscle.
  • Longitudinal surface sliding over the superficial fascia in the posterior arm region.
  • Transverse sliding over the brachial triceps tendon.
  • Transverse sliding for the pectoralis major muscle.
  • Transverse sliding for the posterior axillary region pectoralis major muscle.
  • Induction of the posterior axillary fold.
  • Induction (crossed hands over the brachial region and forearm).
  • Maneuver of transverse planes for the cervicothoracic region.
  • Upper limb telescopic maneuver.
Andra namn:
  • Fascial therapy group
Inget ingripande: Control group
Subjects included in the control group will not receive physical therapy through fascial therapy and will continue with their usual routine of physical activity and exercise, and with the same pharmacological treatment regimen with FVIII / FIX. At the end of the study period the intervention will be applied under the same conditions as the experimental group, analyzing the overall sample at the end of the study.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Change from baseline elbow joint bleeding frequency after treatment and at 3 months
Tidsram: Screening visit, within the first seven days after treatment and after three months follow-up visit
After the first session of physiotherapy patients will be given a self-register where they can record all the observations they feel (from hematomas or hemarthros, to any other discomfort or perception). Similarly, the principal investigator of the study will monitor all patients within 48 hours after each physical therapy session.
Screening visit, within the first seven days after treatment and after three months follow-up visit

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Change from baseline range of motion of elbow after treatment and at 3 months
Tidsram: Screening visit, within the first seven days after treatment and after three months follow-up visit

Change from range of movement of elbow during treatment and follow-up period at 3 months. The range of motion of the elbow joint will be measured using a universal goniometer, using the protocol for measuring joint motion described by Felipe Querol.

Measurement instrument: universal goniometer with the protocol to measurement for patients with hemophilia
Screening visit, within the first seven days after treatment and after three months follow-up visit
Change from baseline elbow joint status after treatment and at 3 months
Tidsram: Screening visit, within the first seven days after treatment and after three months follow-up visit
Change from elbow joint status during treatment and follow-up period at 3 months. Measurement instrument: Haemophilia Joint Health Score (scale 0-20).
Screening visit, within the first seven days after treatment and after three months follow-up visit
Change from baseline joint pain of elbow after treatment and at 3 months
Tidsram: Screening visit, within the first seven days after treatment and after three months follow-up visit
Change from joint pain of ankle during treatment and follow-up period at 3 months.The perception of ankle pain will be measured using visual analog scale (scale 0-10).
Screening visit, within the first seven days after treatment and after three months follow-up visit
Change from baseline upper limb functionality after treatment and at 3 months
Tidsram: Screening visit, within the first seven days after treatment and after three months follow-up visit
Change from upper limb functionality during treatment and follow-up period at 3 months. The perception of ankle pain will be measured using DASH Questionnaire. The Spanish version of this scale used internationally will evaluate upper limb functionality.
Screening visit, within the first seven days after treatment and after three months follow-up visit
Change from baseline quality of life after treatment and at 3 months
Tidsram: Screening visit, within the first seven days after treatment and after three months follow-up visit
Change from quality of life during treatment and follow-up period at 3 months. The quality of life perception will be measured using SF-36 Questionnaire. This scale will assess the perception of quality of life of patients included in the study.
Screening visit, within the first seven days after treatment and after three months follow-up visit

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Real Fundación Victoria Eugenia

Publikationer och användbara länkar

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Allmänna publikationer

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

12 februari 2018

Primärt slutförande (Faktisk)

1 december 2018

Avslutad studie (Faktisk)

15 februari 2019

Studieregistreringsdatum

Först inskickad

30 december 2016

Först inskickad som uppfyllde QC-kriterierna

30 december 2016

Första postat (Uppskatta)

4 januari 2017

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

26 februari 2019

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

25 februari 2019

Senast verifierad

1 februari 2019

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • HeL-Fascial

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

Nej

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