Haemophilia最新文献

{"title":"Haemophilia's Heartland: Pain, Poverty and Patient Care in Faisalabad","authors":"Eesha Yaqoob,&nbsp;Shiza Aftab,&nbsp;Noor-ul-Ain Shah,&nbsp;Nimirta Sahitia,&nbsp;Saad Javed","doi":"10.1111/hae.70009","DOIUrl":"10.1111/hae.70009","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Haemophilia is an inherited bleeding disorder that causes significant pain and disability. Haemophilia A and B are the most common, with HemA affecting more men and being four times more prevalent.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study was conducted in Faisalabad, Pakistan, to assess pain severity in haemophilia patients based on sociodemographic factors and management approaches. Data were collected through structured interviews and analysed using SPSS version 27.0, examining associations between variables and pain severity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A sample of 200 patients was selected from the 800 registered patients at a haemophilia treatment centre (HTC) in Faisalabad. All participants had severe haemophilia, with 65.5% residing in rural areas. Severe pain was reported by 58% of patients, with higher prevalence among rural residents (35% vs. 22.5% urban, <i>p</i> = 0.004) and those with monthly income below Rs. 15,000 (21%, <i>p</i> &lt; 0.001). Plasma transfusion significantly reduced severe pain risk (OR = 0.59, 95% CI: 0.42–0.83, <i>p</i> = 0.003), while self-management methods increased it (OR = 1.79, 95% CI: 1.06–3.02, <i>p</i> = 0.03). Distance from treatment centres significantly impacted pain severity, with 21.5% of patients living within 10–50 miles reporting severe pain. Management practices significantly influenced patient outcomes (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients face significant pain management challenges owing to sociodemographic factors, low income and limited access to specialized care. Addressing these gaps requires early diagnosis, better access to treatment centres and multidisciplinary pain management strategies. While geographic and economic barriers are considered, future research should include detailed data on rural healthcare quality, assimilate longitudinal data and delve into the links between mental health, pain severity and treatment ease of access.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12819,"journal":{"name":"Haemophilia","volume":"31 2","pages":"231-238"},"PeriodicalIF":3.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of the Relationship Between Self-Management and Kinesiophobia in Haemophiliac Individuals Experiencing Intra-Articular Bleeding","authors":"Dilan Çiftci Akan,&nbsp;Mehmet Can Uğur,&nbsp;Esra Oksel","doi":"10.1111/hae.70013","DOIUrl":"10.1111/hae.70013","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This study aims to examine the relationship between self-management skills and kinesiophobia in haemophilia patients. The findings of the study may contribute to the development of strategies that can help haemophilia patients overcome their fear of movement and improve their quality of life (QoL).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study is planned to examine the relationship between disease self-management in haemophiliac individuals and kinesiophobia that may arise from intra-articular bleeding associated with haemophilia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this study, both descriptive and analytical research was conducted on individuals who are members of patient associations. Patient Identification Form, Chronic Disease Self-Management Scale and Tampa Scale for Kinesiophobia were used as data collection tools. Data were collected face to face. Descriptive statistics methods (mean, standard deviation) were used in the evaluation of study data. Quantitative data comparisons were made with the Student's <i>t</i>-test for normally distributed parameters and the Mann–Whitney <i>U</i> test for non-normally distributed parameters. When there were more than two groups, One-Way ANOVA was used, and in advanced analyses, linear regression analysis was used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A positive correlation was found between the ‘self-stigmatization’ subdimension of the Chronic Disease Self-Management Scale and kinesiophobia. Additionally, a negative correlation was observed between healing compliance and kinesiophobia levels. Flexibility in healing cracks was found in the reduction of kinesiophobia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Self-management of the disease in hemophilic individuals affects compliance with treatment, kinesiophobia, activity level and QoL.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12819,"journal":{"name":"Haemophilia","volume":"31 2","pages":"304-312"},"PeriodicalIF":3.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hae.70013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial Care During Novel Therapies in Haemophilia: A Psychological Framework.","authors":"Lotte Haverman, Lorynn Teela, Gráinne O'Brien, Petra Bučková, Gaby Golan, Gloria Rooney, Karolien Bartels, Ana Torres-Ortuño, Christina Burgess","doi":"10.1111/hae.70008","DOIUrl":"https://doi.org/10.1111/hae.70008","url":null,"abstract":"","PeriodicalId":12819,"journal":{"name":"Haemophilia","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recommendations for Psychosocial Support during Gene Therapy: Results From an EAHAD Interdisciplinary Roundtable.","authors":"Lorynn Teela, Gráinne O'Brien, Petra Bučková, Gaby Golan, Gloria Rooney, Karolien Bartels, Ana Torres-Ortuño, Christina Burgess, Lotte Haverman","doi":"10.1111/hae.70005","DOIUrl":"https://doi.org/10.1111/hae.70005","url":null,"abstract":"","PeriodicalId":12819,"journal":{"name":"Haemophilia","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factor VIII Activity and Factor VIII Inhibitors Can Be Measured Accurately in Plasma Containing Mim8 by Using Specific Chromogenic Assays","authors":"William Pickering,&nbsp;Mary Robinson,&nbsp;Caroline Cogswell,&nbsp;Wan Hui Ong Clausen,&nbsp;Karin Nana Weldingh,&nbsp;Mirella Ezban","doi":"10.1111/hae.70007","DOIUrl":"10.1111/hae.70007","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Patients with Haemophilia A treated with Mim8 may require concomitant Factor VIII (FVIII) replacement; hence, accurate assessment of FVIII activity (FVIII:C) and FVIII inhibitors in the presence of Mim8 is important.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Assess which chromogenic substrate assays (CSAs) accurately monitor FVIII:C and FVIII inhibitor levels in the presence of Mim8.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>FVIII and Mim8 were spiked into congenital FVIII-deficient plasma to obtain mixtures containing various FVIII:C levels (0–100 IU/dL) and Mim8 concentrations (0, 3, 6 and 12 µg/mL). Five CSAs using different activated Factor IX and X sources (bovine, bovine–human or human) were used to measure FVIII:C. Bovine and bovine–human CSAs were then used to measure FVIII:C of standard half-life (SHL) and extended half-life (EHL) FVIII products. FVIII inhibitor levels were assessed using two different bovine CSAs in congenital FVIII-deficient plasma spiked with various Mim8 concentrations (5, 10, 20 and 40 µg/mL) and FVIII inhibitor levels (0.2, 1.0 and 4.8 BU).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>High levels of interference were observed using human CSAs. Bovine CSAs accurately measured FVIII:C of SHL and EHL FVIII products in the presence of Mim8 without interference. In bovine–human CSAs, interference was observed at 5 IU/dL FVIII, increasing up to four-fold with increasing Mim8 levels. FVIII inhibitor levels were accurately measured using bovine CSAs without Mim8 interference.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>FVIII:C of SHL and EHL products and FVIII inhibitor levels can be accurately monitored in the presence of Mim8 using bovine CSAs at all FVIII levels, and bovine–human CSAs at FVIII concentrations &gt;20 IU/dL.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12819,"journal":{"name":"Haemophilia","volume":"31 2","pages":"319-327"},"PeriodicalIF":3.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hae.70007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive Analysis of Surgical Interventions for Musculoskeletal Disorders in Patients With Bleeding Disorders: Report From a Subspecialty Unit in a Developing Country.","authors":"Arman Vahabi, Abdussamet Kuyucu, Elcil Kaya Biçer, Fahri Şahin, Kaan Kavaklı, Semih Aydoğdu","doi":"10.1111/hae.70010","DOIUrl":"https://doi.org/10.1111/hae.70010","url":null,"abstract":"","PeriodicalId":12819,"journal":{"name":"Haemophilia","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bleeding Episodes in Patients With Haemophilia B Receiving Prophylactic Factor IX Treatment: A Systematic Review and Meta-Analysis","authors":"Massimo Franchini,&nbsp;Samantha Pasca,&nbsp;Carlo Mengoli,&nbsp;Daniele Focosi,&nbsp;Pier Mannuccio Mannucci","doi":"10.1111/hae.70006","DOIUrl":"10.1111/hae.70006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Prophylaxis with coagulation factor concentrates is the mainstay of treatment in severe hemophilia A and B. Data on bleeding rates in persons with congenital haemophilia B (PwcHB) receiving prophylaxis are inconsistent.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This systematic review and meta-analysis were aimed at assessing bleeding outcomes, including annualised bleeding rates (ABR) and the proportion of patients with zero bleeding events, in PwcHB receiving prophylaxis with plasma-derived or recombinant FIX products with standard (rSHL) or extended half-life (rEHL).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search was conducted using the bibliographic database Medline, Embase and Cochrane Central Register. The protocol was registered on PROSPERO (registration number: CRD42024592785).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The search yielded 2440 citations and a total of 42 studies (2 randomised and 40 nonrandomised) were included in the final analysis. The pooled estimated mean (95% confidence interval [CI]) ABR was significantly lower in PwcHB treated prophylactically with rEHL FIX than in those receiving rSHL FIX products (1.29 [95% CI: 0.91, 1.66] vs. 3.12 [95% CI: 2.63, 3.62], <i>p</i> &lt; 0.01). The proportion of participants with zero bleeding events was significantly higher in PwcHB treated prophylactically with rEHL FIX than in those receiving rSHL FIX (0.53 [95% CI: 0.37, 0.69] vs. 0.24 [95% CI: 0.14, 0.39], <i>p</i> = 0.01). The ABR did not differ according to age groups (more or less than 12 years).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The results of this meta-analysis suggest that compared to standard half-life FIX concentrates, prophylaxis with rEHL FIX products is associated with a reduction in ABR and a higher proportion of patients with no bleeding episodes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12819,"journal":{"name":"Haemophilia","volume":"31 2","pages":"173-186"},"PeriodicalIF":3.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In vitro combined haemostatic efficacy of emicizumab and extended half-life factor VIII compounds","authors":"Laurie Josset,&nbsp;Hamdi Rezigue,&nbsp;Christophe Nougier,&nbsp;Alexandre Leuci,&nbsp;Stéphanie Désage,&nbsp;Anne Lienhart,&nbsp;Yesim Dargaud","doi":"10.1111/hae.15131","DOIUrl":"10.1111/hae.15131","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Early prophylaxis is the gold standard of care for severe haemophilia. The development of subcutaneous Factor VIII (FVIII) mimetics, such as emicizumab, has significantly reduced the disease burden and improved protection against bleeding episodes. Despite its benefits, emicizumab does not fully normalize haemostasis, requiring additional FVIII treatment for surgical procedures and management of breakthrough bleeding. In these cases, extended or ultra-extended half-life FVIII products are most commonly used. However, laboratory monitoring of these combinations can be challenging.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study investigates the in vitro combined haemostatic activity of emicizumab with efmoroctocog alfa and efanesoctocog alfa using a thrombin generation assay (TGA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results and Conclusion</h3>\u0000 \u0000 <p>TGA can be used to monitor combined treatment with emicizumab and either efmoroctocog alfa or efanesoctocog alfa, which is not possible with currently available FVIII reagents for the latter. As expected, there is no synergistic effect between the mimetic and FVIII at therapeutical doses. Both efmoroctocog alfa and efanesoctocog alfa show similar in vitro procoagulant activity in terms of thrombin generation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12819,"journal":{"name":"Haemophilia","volume":"31 2","pages":"224-230"},"PeriodicalIF":3.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143407111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma-Derived von Willebrand Factor/Factor VIII Concentrate (Haemate P) in von Willebrand Disease: A Systematic Review and Pharmacovigilance Update","authors":"Carmen Escuriola Ettingshausen,&nbsp;Riitta Lassila,&nbsp;Gines Escolar,&nbsp;Christoph Male,&nbsp;Kathrin Schirner,&nbsp;Lisa Heyder,&nbsp;Erik Berntorp","doi":"10.1111/hae.15138","DOIUrl":"10.1111/hae.15138","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Von Willebrand disease (VWD) is an inherited bleeding disorder caused by deficient or dysfunctional von Willebrand factor (VWF). VWF replacement therapy is indicated in VWD management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This systematic review was conducted to evaluate all available evidence of the efficacy, safety, dosing and consumption of pasteurized plasma-derived human coagulation FVIII/human VWF (pdVWF/FVIII; Haemate P/Humate-P) concentrate for on-demand (OD) treatment, surgical prophylaxis and long-term prophylaxis of patients with VWD. A systematic search was performed in MEDLINE and Cochrane Library databases to identify studies (7 June 1982–31 May 2023) reporting the use of pdVWF/FVIII in VWD according to predefined selection criteria. Pharmacovigilance data were also retrieved for the same period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifteen studies were identified, 12 being observational and three interventional. Efficacy and safety assessments and treatment protocols varied across the studies which hindered direct comparisons. Haemostatic efficacy of pdVWF/FVIII was rated excellent/good for OD treatment in 95%–98% of bleeds and in 94%–100% of surgeries. In two separate studies, prophylactic efficacy was rated excellent/good in 100% of treatment cycles. Where reported, median annualized bleeding rates decreased from 3–24 prior prophylaxis to 0.5–6 during prophylaxis. Analysis of pharmacovigilance safety reports showed that pdVWF/FVIII was associated with a low rate of adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This systematic literature review and analysis of pharmacovigilance data summarize evidence of over 40 years of clinical use of pdVWF/FVIII, supporting its safety and efficacy in VWD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12819,"journal":{"name":"Haemophilia","volume":"31 2","pages":"247-262"},"PeriodicalIF":3.0,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hae.15138","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Joint and Myofascial Manual Therapy Techniques in Haemophilic Ankle Arthropathy: A Randomized Pilot Study","authors":"Carlos Truque-Díaz,&nbsp;Javier Meroño-Gallut,&nbsp;Rubén Cuesta-Barriuso,&nbsp;Raúl Pérez-Llanes","doi":"10.1111/hae.70002","DOIUrl":"10.1111/hae.70002","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Haemophilic ankle arthropathy is characterized by chronic pain, loss of strength and proprioception, decreased range of motion (ROM) and impaired functionality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the safety and efficacy of a manual therapy protocol based on joint and myofascial techniques in patients with haemophilic ankle arthropathy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A randomized, single-blind pilot study. Twenty-four patients with haemophilia were randomized to the experimental (manual therapy) and control (no intervention) groups. The intervention lasted for 3 weeks, with one 50-min weekly session. Techniques used: active-passive joint mobilization, articulatory technique, joint decompression and high-speed and short-stroke manipulation, and sustained myofascial induction techniques. The study variables were safety of the intervention (number of hemarthroses), joint pain intensity (visual analogue scale), pressure pain threshold (pressure algometer), range of ankle motion (Leg Motion) and joint condition (Haemophilia Joint Health Score).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>None of the patients developed ankle hemarthrosis during the intervention. After the intervention there were intergroup differences in the variables pain intensity (MD = −0.45; <i>p</i> &lt; 0.001), ROM (MD = 0.19; <i>p</i> = 0.003), joint condition (MD = 0.04; <i>p</i> = 0.03) and pressure pain threshold in the internal malleolus (MD = 1.36; <i>p</i> = 0.01). For the interaction <i>time*group</i> after the follow-up period, there were statistically significant differences in pain intensity (<i>F</i> = 6.94; <i>p</i> = 0.01) and dorsal flexion (<i>F</i> = 3.36; <i>p</i> = 0.04) of the ankle.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Manual therapy based on joint and myofascial techniques is safe in haemophilia patients. A protocol implementing joint and myofascial techniques having the dosage and safety parameters established in this study can improve the intensity of pain and dorsal flexion of the ankle in these patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov identifier: NCT05549843</p>\u0000 </section>\u0000 </div>","PeriodicalId":12819,"journal":{"name":"Haemophilia","volume":"31 2","pages":"295-303"},"PeriodicalIF":3.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}