Impact of Physiotherapy and Sports Activities on the Results of Movement Tests in Children with Hemophilia

Introduction

It is well-known that adequate physical activity in the form of sports and rehabilitation provides numerous psychological and physical health benefits, as evidenced by various studies. Mgr. Katzerová presented research on the impact of rehabilitation and physical activity on the results of movement tests in children with hemophilia, conducted with assistance from colleagues Jana Bereňová, Tereza Blatná, Karolína Ptáková, and Táňa Kostovičová. They rejected the null hypothesis that rehabilitation and other physical activities do not influence the results of movement tests, verified in practice during summer camps for children with hemophilia held in 2019-2021.

Methodology and Study Process

Data from 23 camp participants were evaluated in 2019, and from 30 participants in 2020 and 2021. On the first day, participants were evaluated using the Hemophilia Joint Health Score (HJHS), the Timed Up and Go (TUG) test, a 10-meter walk test at normal speed, and a 10-meter walk test at maximum speed. The TUG test is a simple assessment of mobility requiring both static and dynamic balance. It measures the time taken to rise from a chair, walk 3 meters, turn 180 degrees, walk back to the chair, turn 180 degrees again, and sit down. The 10-meter walk test measures the time taken to cover 10 meters at normal speed, and its modification measures the time at maximum speed. The same tests were conducted on the children after 12 days of intensive physiotherapy and sports activities.

During the 2 weeks, children underwent various supervised physical activities, including morning exercises, individual and group physiotherapies, and afternoon exercise programs led by adult hemophiliacs and relatives.

Morning exercises lasted 30 minutes and included yoga, balance exercises, walking, running, stretching, and strengthening exercises. Individual physiotherapies, also lasting 30 minutes, involved soft techniques such as mobilization and manipulation, neurophysiological-based physiotherapy, balance and coordination exercises, and kinesiological taping following individual assessment. If specific joints were affected, therapy focused on those joints. Group therapies, also 30 minutes long, included exercises on bosu balls, with gym balls, thera-bands, relaxation exercises, and balance training (core training).

After a lunch break, children participated in a 15-minute warm-up session including stretching, balancing while standing, athletic warm-up, and preparation for the afternoon program. The varied afternoon program included activities like pool exercises, nordic walking, archery, and team games.

Results

The TUG test showed significant improvement in time after 12 days at the camp (for all years, p < 0.001). The positive effect of rehabilitation and sports activities was also demonstrated in the 10-meter walk test with significant improvements across all years (2019: p <0.014, 2020: p < 0.034, 2021: p < 0.004). For the 10-meter walk test at maximum speed, no significant difference was observed between the first day and after 12 days of intensive physical therapy. In 2021, a significant worsening was observed, potentially due to fatigue from increased overall activity, late bedtimes, and morning tiredness.

Conclusion

The results of this practical study indicate that physical activity and physiotherapy significantly improve movement test results in children with hemophilia in a very short time.

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Source: Katzerová M. Physiotherapy, sports and haemophilia – pediatrics. 9^th Hemophilia Academy, 2021 Oct 5. Available at: www.youtube.com/watch?v=DyUBYoWI3ew