Effectiveness of myofascial therapy (MFT) along with traditional physiotherapy and intermittent prophylaxis on short-term improvement of joint health in hemophilic arthropathy: a randomized control trial

Background: Myofascial therapy (MFT) works on biomechanical soft tissue loading principles aimed to reduce pain, improve tissue mobility and function. Aim: To find effectiveness of MFT and traditional physiotherapy with intermittent prophylaxis on short-term improvement of joint health in hemophilic arthropathy. Research design and methods: Thirty-one patients with Hemophilia A and joint arthropathy (elbows and/or knees) were randomly divided into MFT group (MFT + traditional physiotherapy) and control group (traditional physiotherapy). Both groups received four physiotherapy sessions per week for three weeks and FVIII prophylaxis twice weekly. Haemophilia Joint Health Score (HJHS), Functional Independence Scoring for Haemophilia (FISH), and Range of Motion (ROM) were assessed on Day 0, 10, 21. Results: MFT group demonstrated a significant improvement in their overall HJHS scores (p = 0.016, d = 0.93) and HJHS knee joint scores (p = 0.007, d = 0.57) compared to control group participants. ROM increased substantially in MFT group relative to control group (18.97%; 10.10% improvement in knee and elbow ROM, respectively, vs 9.49%; 1.25%). There was an improvement in FISH scores in both groups, with a slightly greater improvement in control group (13.68% vs 11.08%). Conclusions: MFT is effective and feasible in short-term improvement of joint health in Hemophilia A patients with elbow and knee arthropathy.