PHYSIOTHERAPEUTIC EVALUATION OF JOINT HEALTH OF HEMOPHILIAC PATIENTS THROUGH HEMOPHILIA JOINT HEALTH SCORE (HJHS), RIO DE JANEIRO EXPERIENCE

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. These patients should be constantly evaluated for joint health (assessing the severity of joint damage and musculoskeletal damage) through Hemophilia Joint Health Status (HJHS). HJHS is included in pediatric studies and is also recommended for use in adults, and the validated score is the most sensitive for the physical examination of the joint health.

Purpose: This study aimed to evaluate patients submitted to Radioactive Synovectomy, characterizing their joint health variables through HJHS.

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 submitted to the procedure were evaluated through HJHS one day before the Radioactive Synovectomy by the physiotherapist of the team.

Results: A total of 421 evaluations were performed between February 2016 and February 2020, in patients with a mean age of 19 years, with a preponderance of the target knee joint (213 knee, 109 ankle and 99 elbow). The HJHS Total Score was 15,92, and the Global Gait was 1.27. When we evaluated by age group we identified a worsening in the HJHS Total Score related to more advanced ages, with Score 7,21 in 60 patients from 0 to 10 years old; 12.2 in 196 patients aged 11 to 20 yo; 22.37 in 117 patients aged 21 to 30 yo and 26.33 in 48 patients over 31 yo. Pearson correlation coefficient to HJHS and Age is +0,48.

Conclusions: Therefore, we identified that the profile of patients who arrived to do the procedure in our service is young, with recent joint damage and with a low score in the HJHS, and that over the years joint damage worsens, as well as their functional capacity, identified in the item Global Gait.

Implications: Continuous education of patients, family members, and medical staff to indicate early onset patients for hemophilic arthropathy prevents further joint damage and functional disabilities.

Funding acknowledgements: We didn't have funding

Keywords:
Hemophilia
Joint health
Physiotherapy

Topics:
Disability & rehabilitation
Musculoskeletal
Paediatrics

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