Proof of concept and feasibility of a blended physiotherapy intervention for persons with haemophilic arthropathy. Issue 1 (17th November 2022)

• Record Type: Journal Article
• Authors: Timmer, Merel A.; Kuijlaars, Isolde A. R.; Kloek, Corelien; de Kleijn, Piet; Schutgens, Roger E. G.; Veenhof, Cindy; Pisters, Martijn F.
• Is Part Of: Haemophilia. Volume 29:Issue 1(2023)
• Page Start: 290
• Page End: 307
• Publication Date: 2022-11-17
• Subjects: blended care -- e‐health -- exercise -- haemophilia -- physiotherapy; Hemophilia -- Periodicals; 616.1572005
• DOI: 10.1111/hae.14690
• Languages: English
• ISSNs: 1351-8216

Abstract

Abstract: Background: Regular physiotherapy with a physiotherapist experienced in the field is not feasible for many patients with haemophilia. We, therefore, developed a blended physiotherapy intervention for persons with haemophilic arthropathy (HA) (e‐Exercise HA), integrating face‐to‐face physiotherapy with a smartphone application. Aim: The aim of the study was to determine proof of concept of e‐ Exercise HA and to evaluate feasibility. Methods: Proof of concept was evaluated by a single‐case multiple baseline design. Physical activity (PA) was measured with an accelerometer during a baseline, intervention and post‐intervention phase and analysed using visual inspection and a single case randomisation test. Changes in limitations in activities (Haemophilia Activities List [HAL]) and a General Perceived Effect (GPE) were evaluated between baseline (T0), post‐intervention (T1) and 3 months post‐intervention (T2) using Wilcoxson signed rank test. Feasibility was evaluated by the number of adverse events, attended sessions and open‐ended questions. Results: Nine patients with HA (90% severe, median age 57.5 (quartiles 50.5–63.3) and median HJHS 32 (quartiles 22–36)) were included. PA increased in two patients. HAL increased mean 15 (SD 9) points ( p = .001) at T1, and decrease to mean +8 points (SD 7) ( p = .012) at T2 compared to T0. At T1 and T2 8/9 participants scored a GPE > 3. Median 5 (range 4–7) face‐to‐face sessions were attended and a median 8 out of 12 information modules were viewed. No intervention‐related bleeds were reported. Conclusion: A blended physiotherapy intervention is feasible for persons with HA and the first indication of the effectiveness of the intervention in decreasing limitations in activities was observed.