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Background: Patients with haemophilic arthropathy suffer chronic pain that affects and restricts their quality of life. Visualization of movement through immersive virtual reality is used for pain management. Aim: To evaluate the efficacy of 180‐degree immersive VR motion visualization therapy in patients with haemophilic ankle arthropathy. Methods: Prospective, multicentre pilot study. Fifteen adult patients with bilateral haemophilic ankle arthropathy were recruited (mean age: 42.73 ± 12.36 years). The intervention lasted 4 weeks, with daily home sessions of 180‐degree immersive motion visualization. The patients were given virtual reality glasses to use with their smartphones. From the YouTube mobile app® they accessed the recorded video with access from the He‐Mirror App®. The study variables were joint state (Haemophilia Joint Health Score), pressure pain threshold (pressure algometer), muscle strength (dynamometry) and range of motion (goniometry). Three evaluations were performed: at baseline (T0), after the intervention (T1) and at the end of a 16‐week follow‐up period (T2). Results: No patient developed ankle hemarthrosis during the experimental phase. In the repeated measures analysis we found statistically significant differences in joint state (F = 51.38; η2p =.63), pressure pain threshold of the lateral malleolus (F = 12.34; η2p =.29) and range of motion (F = 11.7; η2p =.28). Conclusions: Therapy using immersive motion visualization does not cause hemarthrosis. This intervention can improve joint condition, pressure pain threshold and range of motion in patients with ankle arthropathy. Changes greater than the MDC were reported in more than 40% of patients for the variables pressure pain threshold, anterior tibialis strength and range of motion, which were considered clinically relevant. [ABSTRACT FROM AUTHOR]

(1) Background: Hemarthrosis is a typical clinical manifestation in patients with hemophilia. Its recurrence causes hemophilic arthropathy, characterized by chronic joint pain. Watching movement recorded from a first-person perspective and immersively can be effective in the management of chronic pain. The objective of this study was to evaluate the effectiveness of an immersive virtual reality intervention in improving the pain intensity, joint condition, muscle strength and range of motion in patients with hemophilic knee arthropathy. (2) Methods: Thirteen patients with hemophilic knee arthropathy were recruited. The patients wore virtual reality glasses and watched a flexion–extension movement of the knee on an immersive 180° video, recorded from a first-person perspective over a 28-day period. The primary variable was the pain intensity (visual analog scale). The secondary variables were the joint status (Hemophilia Joint Health Score), quadriceps and hamstring strength (dynamometry), and range of motion (goniometry). (3) Results: After the intervention period, statistically significant differences were observed in the intensity of the joint pain (Standard error [SE] = 19.31; 95% interval confidence [95%CI] = −1.05; −0.26), joint condition (SE = 18.68; 95%CI = −1.16; −0.52) and quadriceps strength (SE = 35.00; 95%CI = 2.53; 17.47). We found that 38.46% and 23.07% of the patients exhibited an improvement in their quadriceps muscle strength and joint condition above the minimum detectable change for both variables (8.21% and 1.79%, respectively). (4) Conclusions: One hundred and eighty degree immersive VR motion visualization can improve the intensity of joint pain in patients with hemophilic knee arthropathy. An intervention using immersive virtual reality can be an effective complementary approach to improve the joint condition and quadriceps strength in these patients. [ABSTRACT FROM AUTHOR]

• Hemophilic arthropathy is characterized by chronic pain and joint deterioration. • Patients with hemophilia have a poorer quality of life than their peers without hemophilia. • Physiotherapy treatment can improve the quality of life of patients with hemophilic elbow arthropathy. • Manual therapy protocols can improve joint pain and joint health in patients with hemophilia. To evaluate the effect of fascial therapy on the perceived quality of life, pain intensity, and joint health in people with hemophilia. Single-blind randomized controlled trial. Hemophilia Patient Associations. Patients with hemophilia (N=69) were randomly allocated to an experimental group (fascial therapy protocol) or to a control group (no intervention whatsoever). The fascial therapy intervention lasted 3 consecutive weeks with one 45-minute weekly session. The variables evaluated were perceived quality of life (Short Form Health Survey-36), pain intensity (visual analog scale) and joint health (Hemophilia Joint Health Score) at baseline and at 3 and 12 weeks. The mean values of the physical (38.64±9.41 and 41.92±12.16) and mental (45.77±6.25 and 55.02±9.73) components of the Short Form Health Survey-36 improved after the intervention in the experimental group, as well as those for pain intensity and joint health (P <.001). There were differences (P <.001) in the intergroup effect in the physical role variables (F=49.22), emotional role (F=229.71), mental component (F=9.86), intensity of pain (F=24.74), and joint health (F=55.31). A fascial therapy protocol for patients with hemophilic elbow arthropathy can improve their perceived quality of life. Elbow pain intensity improved in patients treated with fascial therapy. This technique can improve elbow joint health. [ABSTRACT FROM AUTHOR]

Background: Pain is a major characteristic in haemophilic arthropathy. Identifying the psychosocial variables affected by pain can help when addressing these patients. Aim: To assess the relationship between perceived intensity of chronic pain and joint damage, kinesiophobia, catastrophism, anxiety and perceived quality of life in adult patients with haemophilic arthropathy. Methods: Multicentre cross‐sectional descriptive study. Seventy‐seven adult patients with haemophilic arthropathy were recruited. The usual and maximum pain intensity (Visual Analog Scale), joint status (Haemophilia Joint Health Score), Kinesiophobia (Tampa Scale of Kinesiophobia), catastrophism (Pain catastrophizing scale), anxiety (State‐Trait Anxiety inventory) and perceived quality of life (36‐Item Short Form Health Survey) were evaluated. The correlation between usual and maximum pain intensity with quantitative variables was obtained with Spearman's correlation test. Kruskal‐Wallis one‐way ANOVA analysed differences in perceived pain according to the severity and type of treatment, and development of inhibitors. Results: The usual intensity of perceived pain correlated positively with catastrophism, kinesiophobia, and state and trait anxiety. The same results were obtained when analysing the maximum perception of pain. We found an inverse correlation between the physical component of perceived quality of life and usual and maximum pain intensity perceived by patients. Conclusion: Psychosocial factors affect the painful experience of patients with haemophilic arthropathy. Pain intensity affects the quality of life of these patients. [ABSTRACT FROM AUTHOR]

Background: Haemophilic arthropathy is characterized by joint restrictions. One of the most affected joints in haemophilia patients is the knee. Aim: This study evaluates the effectiveness of manual therapy and passive muscle stretching exercises for reducing the frequency of hemarthrosis and pain and improving joint health and range of motion in patients with haemophilic knee arthropathy. Methods: Twenty eight patients with haemophilic knee arthropathy were randomized to an experimental group or to a control group (without intervention). Manual therapy sessions included joint traction and gliding manoeuvers, in addition to passive muscle stretching. The intervention included one 60‐minute with two weekly sessions over a 12‐week period. We evaluated the frequency of knee hemarthrosis (self‐reporting), joint health (Hemophilia Joint Health Score), range of motion (goniometry) and perceived knee pain (visual analogue scale). A baseline evaluation was performed at the end of the intervention and after a 12‐week follow‐up period. Results: The frequency of hemarthrosis dropped significantly in the experimental group compared to the control group (F = 11.43; P <.001). Compared to the control group, the experimental group had consistently better results in the variables for joint health (F = 13.80; P <.001), range of motion in knee flexion (F = 24.29; P <.001) and loss of extension (F = 8.90; P <.001), and perceived pain (F = 49.73; P <.001). Conclusions: Manual therapy using joint traction and gliding manoeuvers, in addition to passive muscle stretching, reduces the frequency of hemarthrosis in patients with haemophilia. Manual therapy with passive muscle stretching exercises improves joint health, range of motion and perceived joint pain. [ABSTRACT FROM AUTHOR]