The effects of close kinetic chain exercises on proprioception and physical activity level in pediatric patients with hemophilia.

Abstract

Knee joint proprioception is affected, and lower extremity functioning declines over time in patients with hemophilia A. To investigate the effects of a structured exercise programme consisting of the close kinetic chain (CKC) exercises on proprioception and physical activity level in pediatric patients with hemophilia. A total of 21 patients with hemophilia A who had at least one target knee joint were randomized into three groups: Study Group (SG, n=7), Conventional Treatment Group (CTG, n=7) and Control Group (CG, n=7). The SG received a structured, lower limb-specific exercise protocol consisting of CKC exercises 2 days a week for 12weeks, in addition to prophylactic treatment. The CTG received exercise training as described in the published literature. The CG continued to receive prophylactic treatment during the study period. Proprioception was measured using a digital goniometer before and after treatment in open and closed kinetic chain positions (CKCPs). The Five Times Sit to Stand (STS), Timed Up and Go (TUG) and Functional Independence Score in Hemophilia were used for the assessment of physical activity level. A significant pre/post-treatment difference was found among the groups in proprioception (p=.001) and physical activity level (TUG p=.008, STS p=.001, FISH p=.006). Improvements in proprioception and physical activity level were greater in the SG compared to the other two groups (p<.05). Compared to conventional exercise, the structured exercise protocol consisting of CKC exercise training produced improvements in proprioception and physical activity in patients with hemophilia A.