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Published on: July 14, 2023
Musculoskeletal Changes in Hemophilia Patients Subsequent to COVID-19 Lockdown
Rubén Cuesta-Barriuso1,2, Javier Meroño-Gallut3, Raúl Pérez-Llanes4
1Department of Physiotherapy, University of Murcia, 30100 Murcia, Spain.
Insights
COVID-19 lockdowns negatively impacted physical activity, worsening joint health and pain in hemophilia patients. However, hemarthrosis frequency did not increase, suggesting proactive management can mitigate sedentary effects.
Area of Science:
- Orthopedics
- Hematology
- Physical Therapy
Background:
- COVID-19 lockdowns led to reduced physical activity.
- Hemophilia causes joint deterioration via hemarthrosis.
- Assessing the impact of reduced activity on hemophilia joint health is crucial.
Purpose of the Study:
- To evaluate the effects of COVID-19 lockdown on the musculoskeletal status of patients with hemophilia and arthropathy.
- To analyze changes in joint condition, pain, range of motion, and hemarthrosis frequency.
Main Methods:
- Observational study of 27 hemophilia patients with arthropathy.
- Assessment of knee, ankle, and elbow joints.
- Evaluation of clinical hemarthrosis frequency, pain intensity, pressure pain threshold, and joint range of motion (ROM).
Main Results:
- Significant deterioration in joint condition, pain, and ROM observed post-lockdown.
- No change in knee hemarthrosis frequency; ankle hemarthrosis decreased; elbow hemarthrosis increased.
- Severity, treatment type (prophylaxis vs. on-demand), and inhibitors influenced outcomes in specific joints.
Conclusions:
- COVID-19 lockdown adversely affected the musculoskeletal status of hemophilia patients.
- Joint health, pain, and ROM were significantly impacted, but hemarthrosis frequency did not rise.
- An active therapeutic model is recommended to prevent deterioration during prolonged sedentary periods in hemophilic arthropathy.
Abstract:
(1) Background. The lockdown period due to the COVID-19 pandemic has drastically decreased levels of physical activity in the population. Hemophilia is characterized by hemarthrosis that leads to chronic, progressive and degenerative joint deterioration. (2) Methods. This observational study recruited 27 patients with hemophilia and arthropathy. Knee, ankle and elbow joints were assessed. The frequency of clinical hemarthrosis, pain intensity, pressure pain threshold, and joint ROM were evaluated. (3) Results. Following lockdown, a significant deterioration of joint condition, perceived joint pain and range of motion was noted in all joints. There were no changes in the frequency of knee hemarthrosis, while the frequency of ankle hemarthrosis significantly reduced. However, the frequency of elbow hemarthrosis increased. Depending on the degree of hemophilia severity, there were changes in pressure pain threshold in the elbow and in pain intensity and range of motion of the ankle joint. According to the type of treatment, i.e., prophylaxis vs. on-demand treatment, there were differences in the joint condition in elbows and the plantar flexion movement of the ankle. There were no differences in the knee joint based on the severity of the disease, the type of treatment or the development of inhibitors (4). Conclusions. Because of the COVID-19 lockdown, the musculoskeletal status of patients with hemophilia deteriorated. Joint condition, perceived pain, and range of motion were significantly affected. The frequency of clinical hemarthrosis did not increase during this period. A more active therapeutic model could prevent rapid deterioration in patients with hemophilic arthropathy during prolonged sedentary periods.
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