Exercise for haemophilia.

摘要: Background Haemophilia is a bleeding disorder associated with haemorrhaging into joints and muscles. Exercise often used to aid recovery after bleeds, improve joint function in the presence of arthropathy. Objectives Our objective was systematically review available evidence on safety effectiveness exercise for people haemophilia. Search methods We searched Cochrane Cystic Fibrosis Genetic Disorders Group's Coagulopathies Trials Register electronic databases PubMed, OVID-Embase, CINAHL. We hand abstracts from congresses World Federation Hemophilia European Hematology Association, trial registries reference lists relevant articles. Date last search Register: 14 December 2016. Selection criteria Randomized or quasi-randomized controlled studies comparing any intervention considered haemophilia management including supervised, unsupervised, aquatic, strengthening, aerobic cardiovascular, stretching, proprioceptive balance training programs males age A B severity (those co-morbidities were not excluded). Data collection analysis Two authors reviewed identified determine their eligibility. For meeting inclusion criteria, full articles obtained. The two extracted data assessed risk bias. Any disagreements resolved by discussion. contacted study investigators obtain missing data. Main results Eight included, which represented 233 all severities B, ranging eight years 49 years. Study duration ranged four 12 weeks. interventions varied greatly included resistance exercises, isometric bicycle ergometry, treadmill walking hydrotherapy; therefore, comparison between difficult. None measured reported adverse effects interventions. None outcomes regarding bleed frequency, quality life activity. Overall bias across as unclear. Very few provided sufficient information comparison. that favoured control group. One six weeks improved health status (Colorado score) compared controls. addition pulsed electromagnetic fields also ankle scores exercises alone, but this seen elbows knees. Two statistically significant improvements pain intensity Hydrotherapy produced decreases controls land-based groups. Two found improvement motion group land- water-based exercises; there no difference range groups; however, did show over group. One study, traction neuromuscular facilitation elbow group, showed differences biceps girth strength intervention. Some comparisons In one significantly children ergometry. Another added partial weight bearing quadriceps tolerance. Four evaluated hamstring (or both). ergometry weights more effective than static strengthening knee flexors extensors. Partial weight-bearing through short arc improving extensor strength. ultrasound, stretching increased peak torque extensors decrease effusion. The results should be interpreted caution due (GRADE) outlined summary findings tables, demonstrates rated low very small sample sizes potential bias. Authors' conclusions These must caution. There lack confidence number inability pool heterogeneity outcome measures. Most pain, motion, tolerance. may land relief adults. Functional such seem muscle These are consistent many non-controlled reports literature. No result However, some groups prophylactic factor prior other studied only subjects moderate haemophilia. Therefore, these techniques persons severe remains unclear.