Effects of Physical Therapy on Joint Pain, Joint Range of Motion, Joint Health, Strength, and Mobility in Patients With Hemophilia

ABSTRACT Objective This study investigated the effects of physical therapy (PT), including exercise, manual therapy, and physical agent modality, on joints, muscle strength, and mobility of patients with hemophilia. Methods PubMed, Embase, MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus were searched from inception to September 10, 2022. Randomized controlled trials (RCTs) comparing pain, range of motion (ROM), and health of joints, as well as muscle strength and mobility (timed up and go test [TUG]) between PT and control groups were included. Results Fifteen RCTs with 595 male patients with hemophilia were included. In comparisons between PT and control groups, PT significantly reduced joint pain (standardized mean difference [SMD] = −0.87; 95% confidence interval [CI], −1.14 to −0.60), increased joint ROM (SMD = 0.24; 95% CI, 0.14–0.35), enhanced joint health (SMD = −1.08; 95% CI, −1.38 to −0.78), improved muscle strength (SMD = 1.42; 95% CI, 1.16–1.69) and TUG performance (SMD = −1.25; 95% CI, −1.89 to −0.60). The comparisons demonstrate moderate to high evidentiary quality grades. Conclusions PT is effective in reducing pain, increasing joint ROM, and enhancing joint health, as well as improving muscle strength and mobility in patients with hemophilia.