Document Detail


Effects of a 6-week, individualized, supervised exercise program for people with bleeding disorders and hemophilic arthritis.
MedLine Citation:
PMID:  20203091     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: People with bleeding disorders may develop severe arthritis due to joint hemorrhages. Exercise is recommended for people with bleeding disorders, but guidelines are vague and few studies document efficacy. In this study, 65% of people with bleeding disorders surveyed reported participating in minimal exercise, and 50% indicated a fear of exercise-induced bleeding, pain, or physical impairment. OBJECTIVE: The purpose of this study was to examine the feasibility, safety, and efficacy of a professionally designed, individualized, supervised exercise program for people with bleeding disorders. DESIGN: A single-group, pretest-posttest clinical design was used. METHODS: Thirty-three patients (3 female, 30 male; 7-57 years of age) with mild to severe bleeding disorders were enrolled in the study. Twelve patients had co-existing illnesses, including HIV/AIDS, hepatitis, diabetes, fibromyalgia, neurofibromatosis, osteopenia, osteogenesis imperfecta, or cancer. Pre- and post-program measures included upper- and lower-extremity strength (force-generating capacity), joint range of motion, joint and extremity circumference, and distance walked in 6 minutes. Each patient was prescribed a 6-week, twice-weekly, individualized, supervised exercise program. Twenty participants (61%) completed the program. RESULTS: Pre- and post-program data were analyzed by paired t tests for all participants who completed the program. No exercise-induced injuries, pain, edema, or bleeding episodes were reported. Significant improvements occurred in joint motion, strength, and distance walked in 6 minutes, with no change in joint circumference. The greatest gains were among the individuals with the most severe joint damage and coexisting illness. LIMITATIONS: Limitations included a small sample size with concomitant disease, which is common to the population, and a nonblinded examiner. CONCLUSIONS: A professionally designed and supervised, individualized exercise program is feasible, safe, and beneficial for people with bleeding disorders, even in the presence of concomitant disease. A longitudinal study with a larger sample size, a blinded examiner, and a control group is needed to confirm the results.
Authors:
Ruth Mulvany; Audrey R Zucker-Levin; Michael Jeng; Catherine Joyce; Janet Tuller; Jonathan M Rose; Marion Dugdale
Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-03-04
Journal Detail:
Title:  Physical therapy     Volume:  90     ISSN:  1538-6724     ISO Abbreviation:  Phys Ther     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-02     Completed Date:  2010-05-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0022623     Medline TA:  Phys Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  509-26     Citation Subset:  AIM; IM    
Affiliation:
Department of Physical Therapy, College of Allied Health Sciences, University of Tennessee Health Science Center, 930 Madison Ave, 6th Floor, Memphis, TN 38163, USA. rmulvaney@uthsc.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Arthritis / physiopathology,  rehabilitation*
Blood Coagulation Disorders / physiopathology*
Child
Exercise*
Feasibility Studies
Female
Humans
Male
Middle Aged
Muscle Strength / physiology
Range of Motion, Articular / physiology
Severity of Illness Index
Walking / physiology
Young Adult

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