Effects of a 6-Week, individualized, supervised exercise program for people with bleeding disorders and hemophilic arthritis

Ruth Mulvany, Audrey Zucker-Levin, Michael Jeng, Catherine Joyce, Janet Tuller, Jonathan M. Rose, Marion Dugdale

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background. People with bleeding disorders may develop severe arthritis due to joint hemorrhages. Exercise is recommended for people with bleeding disorders, but guidelines are vague and few studies document efficacy. In this study, 65% of people with bleeding disorders surveyed reported participating in minimal exercise, and 50% indicated a fear of exercise-induced bleeding, pain, or physical impairment. Objective. The purpose of this study was to examine the feasibility, safety, and efficacy of a professionally designed, individualized, supervised exercise program for people with bleeding disorders. Design. A single-group, pretest-posttest clinical design was used. Methods. Thirty-three patients (3 female, 30 male; 7-57 years of age) with mild to severe bleeding disorders were enrolled in the study. Twelve patients had coexisting illnesses, including HIV/AIDS, hepatitis, diabetes, fibromyalgia, neurofibromatosis, osteopenia, osteogenesis imperfecta, or cancer. Pre- and post-program measures included upper- and lower-extremity strength (force-generating capacity), joint range of motion, joint and extremity circumference, and distance walked in 6 minutes. Each patient was prescribed a 6-week, twice-weekly, individualized, supervised exercise program. Twenty participants (61%) completed the program. Results. Pre- and post-program data were analyzed by paired t tests for all participants who completed the program. No exercise-induced injuries, pain, edema, or bleeding episodes were reported. Significant improvements occurred in joint motion, strength, and distance walked in 6 minutes, with no change in joint circumference. The greatest gains were among the individuals with the most severe joint damage and coexisting illness. Limitations. Limitations included a small sample size with concomitant disease, which is common to the population, and a nonblinded examiner. Conclusions. A professionally designed and supervised, individualized exercise program is feasible, safe, and beneficial for people with bleeding disorders, even in the presence of concomitant disease. A longitudinal study with a larger sample size, a blinded examiner, and a control group is needed to confirm the results.

Original languageEnglish (US)
Pages (from-to)509-526
Number of pages18
JournalPhysical Therapy
Volume90
Issue number4
DOIs
StatePublished - Apr 1 2010

Fingerprint

Arthritis
Exercise
Hemorrhage
Joints
Sample Size
Pain
Osteogenesis Imperfecta
Neurofibromatoses
Fibromyalgia
Metabolic Bone Diseases
Articular Range of Motion
Hepatitis
Fear
Longitudinal Studies
Lower Extremity
Edema
Acquired Immunodeficiency Syndrome
Extremities
HIV
Guidelines

All Science Journal Classification (ASJC) codes

  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Effects of a 6-Week, individualized, supervised exercise program for people with bleeding disorders and hemophilic arthritis. / Mulvany, Ruth; Zucker-Levin, Audrey; Jeng, Michael; Joyce, Catherine; Tuller, Janet; Rose, Jonathan M.; Dugdale, Marion.

In: Physical Therapy, Vol. 90, No. 4, 01.04.2010, p. 509-526.

Research output: Contribution to journalArticle

Mulvany, Ruth ; Zucker-Levin, Audrey ; Jeng, Michael ; Joyce, Catherine ; Tuller, Janet ; Rose, Jonathan M. ; Dugdale, Marion. / Effects of a 6-Week, individualized, supervised exercise program for people with bleeding disorders and hemophilic arthritis. In: Physical Therapy. 2010 ; Vol. 90, No. 4. pp. 509-526.
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abstract = "Background. People with bleeding disorders may develop severe arthritis due to joint hemorrhages. Exercise is recommended for people with bleeding disorders, but guidelines are vague and few studies document efficacy. In this study, 65{\%} of people with bleeding disorders surveyed reported participating in minimal exercise, and 50{\%} indicated a fear of exercise-induced bleeding, pain, or physical impairment. Objective. The purpose of this study was to examine the feasibility, safety, and efficacy of a professionally designed, individualized, supervised exercise program for people with bleeding disorders. Design. A single-group, pretest-posttest clinical design was used. Methods. Thirty-three patients (3 female, 30 male; 7-57 years of age) with mild to severe bleeding disorders were enrolled in the study. Twelve patients had coexisting illnesses, including HIV/AIDS, hepatitis, diabetes, fibromyalgia, neurofibromatosis, osteopenia, osteogenesis imperfecta, or cancer. Pre- and post-program measures included upper- and lower-extremity strength (force-generating capacity), joint range of motion, joint and extremity circumference, and distance walked in 6 minutes. Each patient was prescribed a 6-week, twice-weekly, individualized, supervised exercise program. Twenty participants (61{\%}) completed the program. Results. Pre- and post-program data were analyzed by paired t tests for all participants who completed the program. No exercise-induced injuries, pain, edema, or bleeding episodes were reported. Significant improvements occurred in joint motion, strength, and distance walked in 6 minutes, with no change in joint circumference. The greatest gains were among the individuals with the most severe joint damage and coexisting illness. Limitations. Limitations included a small sample size with concomitant disease, which is common to the population, and a nonblinded examiner. Conclusions. A professionally designed and supervised, individualized exercise program is feasible, safe, and beneficial for people with bleeding disorders, even in the presence of concomitant disease. A longitudinal study with a larger sample size, a blinded examiner, and a control group is needed to confirm the results.",
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