The effect of exercise training on pain, physical activity and quality of life in patients with pediatric hemophilia

The aim of the study was to examine the effect of exercise training on pain, physical activity and quality of life in patients with pediatric hemophilia. A total of Hemophilia A 21 patients with a target joint in the knee were included in the study. The patients were divided into 3 groups using the simple randomization method: the study group, the classical treatment group, and the control group. In addition to the prophylaxis treatment, the patients in the study group were given an exercise protocol consisting of lower extremity-specific closed kinetic chain, co-contraction and core stabilization, 2 days a week for 12 weeks, and exercise training in the literature in the classical treatment group. The patients in the control group continued their prophylaxis treatments for 12 weeks. Before and after the treatment, proprioception and range of motion (ROM) of the patients regarding the musculoskeletal system were made with a digital goniometer, and muscle shortening measurement were made with a tape measure. Joint health was assessed with the Hemophilia Joint Health Score (HJHS). Mc Gill Short Form scale was used for pain. In the evaluation of physical activity, Timed Up and Go Test (TUG), 5 Times- Sit-to-Stand test (5STS), 2 Minutes Walk Test (2MWT) and Hemophilia Functional Independence Score (FISH) were used. Quality of life was assessed with the Pediatric Quality of Life Inventory (PedsQL). The effect of the exercise protocol applied to the patients in the study group on proprioception was higher than the other two groups (p<0.05). Although ROM and muscle shortening measurements increased in the study and classical treatment groups, the results were similar between the three groups at the end of the treatment (p>0.05). There was a difference between the groups after treatment in HJHS (p<0.05). The patients in the study group showed better recovery than the other two groups. Post-treatment pain, physical activity and improvement in FISH were higher in the study group than in the other two groups (p<0.05). Although PedsQL increased at the end of treatment in the study group compared to before treatment, the results were similar between the groups (p>0.05). It was concluded that the developed exercise protocol is more effective on proprioception, joint health, pain, physical activity and functional independence and can be included in rehabilitation programs.