Impact of Biofeedback Training on Functional Improvement In Hemophilic Arthropathy

Abstract

Hemarthrosis (hemorrhage into the joints) is the most common complication in patients with severe hemophilia A. This bleeding is painful and leads to long-term inflammation and deterioration of the joint resulting in permanent deformities, misalignment, loss of mobility, and extremities of unequal lengths. The most commonly affected joint in patients not treated with prophylaxis is knee joint (45%). Quadriceps atrophy following repeated hemophilic joint arthropathy causes instability of the joint, producing repeated falls and bleeding episodes, and hastens the development of serious joint destruction. Hence quadriceps strength is a vital component of lower limb function. Our aime was to evaluate the role of biofeedback in functional improvement of hemophilic knee arthropathy in order to implement most satisfactory management for prevention of complications. We conducted our study on 30 hemophilic pediatric patients. They were classified into 2 groups (A&B) each of which included 15 patients. All patients were subjected to history taking, clinical examination, and laboratory investigations as factor VIII assay, CBC, PTT, and Pt . Group (A) underwent strengthening exercises on quadriceps mucle, while group (B) attended sessions of electromyographic biofeedback (EMGBF). Both groups were assessed before and after rehabilitation program by functional scoring (HJHS, FISH), measurement of mid-thigh circumference, muscle strength by modified sphygmomanometer and EMG reading as read by EMG Biofeedback.

Statistical analysis revealed:  There was a non-statistical significant difference between both studied groups regarding age and factor administration.