Impact Of Exercise Therapy In Patients With Hemophiliac Arthritis

Objective : To explore the clinical effect of exercise therapy in the treatment of hemophiliac arthritis.Methods: A total of 28 patients(3 elbow,27 knee,25 ankle)diagnosed with hemophiliac arthritis admitted to the Department of hematology and Rehabilitation Medicine of our hospital from April 2021 to November 2022 were enrolled and divided into three groups according to the degree of injury of the affected joints: mild(3 elbow,3 knee,9 ankle),moderate(9 knee,11 ankle)and severe(15 knee,5 ankle).Before and after treatment,the patients’ joint health status,ability to perform activities of daily living and health-related quality of life were assessed by the Hemophilia Joint Health Scale(HJHS),the Hemophilia Function Independent Scale(FISH),the ultrasonic joint HEAD-US-C scoring system and the health status questionnaire SF-36.According to the degree of dysfunction(pain,limitation of joint movement and muscle strength,etc.)and mobility(standing,walking and going up and down stairs,etc.)of the affected joint,a reasonable treatment plan should be formulated for the patient,including soft tissue stretching,muscle strength training,proprioceptive and balance function training and functional training.Exercise therapy should be carried out once a day.Each session lasted about 40-60 minutes five times a week for six weeks.spss22.0 was used for statistical analysis.Results:1.The total joint score of HJHS scale in mild and moderate groups decreased after treatment,and the difference was statistically significant(P<0.05),the scores of all items in the HJHS scale were lower after treatment than before treatment,and improved(P<0.05);The total joint score of HJHS scale in severe group was lower after treatment than before treatment,and the difference was statistically significant(P<0.05),the scores of swelling,muscle atrophy,arthralgia,muscle strength and other items on the HJHS scale were lower after treatment than before treatment,and all were improved(P<0.05),and the frictional sound,flexion reduction and extension reduction were not significantly improved(P>0.05);A comparison of the results of the three groups showed that the improvement of total joint scores in the mild and moderate groups was better than that in the severe group(P<0.05).2.The total score of hemophilia Functional Independent Scale(FISH)increased from 21.11±4.06 points before treatment to 26.18±3.91 points after treatment,and the difference was statistically significant(P<0.05),the degree of completion of all programs was improved compared with that before treatment(P<0.05).3.The total score of SF-36 scale of health status questionnaire increased from494.53±166.3 points before treatment to 626.39±107.66 points after treatment,and the difference was statistically significant(P<0.05),and the scores of all items were higher than before treatment,and the improvement was obvious(P<0.05).4.There were statistically significant differences in ultrasonic HEAD-US-C scores between the mild injury group and the moderate injury group before and after treatment(P<0.05),there was no significant difference in ultrasonic HEAD-US-C score before and after treatment in the severe injury group(P<0.05).Conclusion(s):1.Exercise therapy can improve joint health in patients with hemophiliac arthritis,and early intervention is more effective.2.Exercise therapy can improve daily activity ability and health-related quality of life in HA patients.3.The effect of exercise therapy on the injury of joint structure is not obvious.4.Exercise therapy is a safe and effective therapeutic measure.