Safety of strength training with blood flow restriction in patients with hemophilic arthropathy; a randomized pilot study.

Introduction: Hemophilic arthropathy is characterized by chronic pain, decreased joint range and periarticular muscle atrophy. In the absence of suitable prophylactic treatment, these sequelae cause severe disability from early ages. The aim of this study was to evaluate the safety of applying blood flow restriction in patients with hemophilia and to observe changes in pain intensity, range of motion and muscle strength.

Methods: A randomized, single-blind pilot study. Twenty-three patients were recruited and randomized to the two study groups: experimental (training with blood flow restriction) and control (no intervention). The intervention, which lasted for 3 weeks with two weekly sessions, included strengthening exercises of the quadriceps muscle and the plantiflexor and dorsiflexor muscles. The study variables were: safety (number of bleeds), pain intensity (Visual Analog Scale), range of motion (goniometry) and muscle strength (dynamometry).

Results: None of the patients with hemophilia who received the intervention developed muscle or joint bleeds during the study phase. There were statistically significant intergroup differences (p < .001) in the intensity of knee pain (F = 17.97; ŋ²_p = 0.29) and ankle pain (F = 24.84; ŋ²_p = 0.36), and quadriceps muscle strength (F = 23.49; ŋ²_p = 0.34).

Conclusions: Strength training with blood flow restriction is safe and does not cause joint or muscle bleeding in hemophilia patients in this group. Low-load and flow-restriction exercises can improve the intensity of joint pain and periarticular muscle strength in patients with bilateral hemophilic knee and ankle arthropathy.