HEMOPHILIC ARTHROPATHY: EFFECTS OF A PHYSIOTHERAPY PROGRAM ON HEALTH-RELATED QUALITY OF LIFE IN INDIVIDUALS WITH CHRONIC PAIN

• Grant number: 23/01562-4
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• Start date: May 01, 2025
• End date: April 30, 2028
• Field of knowledge: Health Sciences - Physiotherapy and Occupational Therapy
• Principal Investigator: Marcelo Tavella Navega
• Grantee: Vanessa Girotto Guedes
• Host Institution: Faculdade de Filosofia e Ciências (FFC). Universidade Estadual Paulista (UNESP). Campus de Marília. Marília , SP, Brazil

Abstract

Hemarthroses, despite the therapeutic advances in hemophilia, remain the most frequent clinical events. The hemarthroses of repetition lead to chronic synovitis and terminal arthropathy at an early age. Muscle weakness, contractures, reduced functional capacity and chronic pain are directly associated with chronic degenerative changes that are installed early in hemophilia. Physical therapy plays a crucial role in the prevention and rehabilitation of Persons with Hemophilia (PWH). Treatments such as hydrotherapy and/or supervised personalized kinesiotherapy programs improve static and dynamic balance, muscle strength, proprioception and pain, with consequent improvement in health-related quality of life (HRQoL). In Brazil, there is a lack of knowledge regarding the different physiotherapeutic techniques and approaches and the associations with the improvement of pain, muscle strength and HRQoL. The objective of this study is to characterize joint health, develop an individual and personalized physiotherapeutic treatment plan and verify the impact of this treatment on the perception and intensity of pain and HRQoL in a sample of PWH residents in the Midwest region of São Paulo. This is an intervention, longitudinal and prospective analysis study in patients with hemophilia A or B and who have chronic pain. Sociodemographic and clinical data, functional assessment, muscle strength, investigation of numbers of hemarthroses in the target joint, pain assessment and HRQoL before the intervention and after every six months of physical therapy treatment will be collected, with mean pain and HRQoL being the primary outcomes analyzed. With regard to secondary outcomes, the following will be evaluated: Muscle torque, musculoskeletal function and the number of hemarthroses before and after every six months. Regarding the hypotheses of this study, we can consider three, namely: 1) Individualized physiotherapeutic treatment modifies the perception of chronic pain and HRQoL; 2) Physical therapy increases the torque of the muscles related to the target joint; and 3) The number of hemarthroses decreases after six months of specialized and individualized physiotherapeutic treatment.