CORRELATIONS BETWEEN SCORES: HJHS AND FISH, IN THE PHYSIOTHERAPEUTIC EVALUATION OF HEMOPHILIAC PATIENTS, REFERRED TO RADIOACTIVE SYNOVECTOMY, IN BRAZIL

¹Federal University of Rio de Janeiro, Physiotherapy, Rio de Janeiro, Brazil

Background: Hemophilic arthropathy is the main object of the physiotherapist's performance in patients with hemophilia. The joint health of these patients should be constantly evaluated, assessing the severity of joint damage and musculoskeletal injury (using the Hemophilia Joint Health Status - HJHS) and their functional status using the Functional Independence Measure for Hemophilia (FISH).

Purpose: The study aimed to evaluate patients undergoing Radioactive Synovectomy and establish a correlation between the HJHS and FISH assessment instruments (Pearson's correlation coefficient).

Methods: It was carried out at the national referral center of this procedure, with the proper authorization of patients and caregivers and approved by the Research Ethics Committee. All patients were evaluated through HJHS and FISH one day before the Radioactive Synovectomy, by the physiotherapist group. The two scores used are recommended and validated by the World Federation of Hemophilia as monitoring tools for hemophiliac patients. The two scores used are recommended and validated by the World Federation of Hemophilia as monitoring tools for hemophiliac patients. The HJHS is used to assess anthropometric criteria that show joint health and the FISH is used to identify the functionality of these patients based on the domains: self-care, transfers and mobility.

Results: 200 assessments were performed from 2018 to date, with a mean age of patients of 19.38 years, with the knees being the most frequent target joint. of 1.2 points. When dividing by age group, we found HJHS Total Score of 8.0 points, FISH 28.85 points in 34 patients aged 0 to 10 years; HJHS of 12.3 points, FISH 29.17 points in 92 patients aged 11 to 20 years; HJHS 22.9 points, FISH 26.6 points in 48 patients aged 21 to 30 years and HJHS 26.2 points, FISH 23.38 points in 26 patients over 30 years. Pearson's correlation for HJHS and Age is +0.48; FISH and Age is -0.42 and HJHS and FISH is -0.58, thus being a moderate negative correlation.

Conclusions: Thus, we could identify that the greater the age, the greater the HJHS score, which means greater joint health damage. Moreover, the older the patient is, the lower the FISH score also is, meaning less functional independence of these patients. Thus, these two instruments are fundamental for the evaluation, since the Scores are inversely proportional and the age was the determining variable for both.

Implications: This study highlights the need for the physical therapist who assists hemophilic patients to have in their routine the evaluation of joint health by the HJHS and the functionality by the FISH, as this will be able to follow the evolution of arthropathy and guide good physical therapy practices.

Funding acknowledgements: The work had no financial support.

Keywords:
Hemophilia
Functionality
Physiotherapy

Topics:
Musculoskeletal
Disability & rehabilitation
Orthopaedics

Did this work require ethics approval? Yes

Institution: Federal University of Rio de Janeiro

Committee: Clementino Fraga Filho Hospital

Ethics number: 19613719.6.0000.5257