Manual therapy in the treatment of ankle hemophilic arthropathy

Despite physiotherapy’s having demonstrated effectiveness in preventing ankle arthropathy compared to prophylaxis treatment from early ages, there haven’t been any conclusive studies examining physiotherapy intervention once hemophilic arthropathy of the ankle has been established. This study’s objective was to evaluate the effectiveness of two physiotherapy interventions, in patients with hemophilic arthropathy of the ankle that had not been operated on previously. Nine patients with hemophilia (mean age of 35.7 SD 11.9 years) were randomized to a mobilization group (n = 5) and manual therapy group (n = 4). The two physiotherapy interventions were: (1) passive mobilization and stretching; and (2) manual orthopaedic therapy, both with proprioception training. The study lasted for six weeks, with two sessions a week. Ankle mobility and pain perception, lower limb proprioception and quality of life were the outcome measures. Both treatments improved all ankle movements (p < 0.05). The treatment with passive mobilizations also improved the perception of pain and quality of life. After six months, both groups still had improved articular movement with the exception of plantar flexion and continued to perceive less pain.

Both physiotherapy interventions improved the range of movement and reduced pain in patients with ankle arthropathy. No haemarthrosis was recorded during treatment or during the follow-up period.

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