The Role of Physiotherapy and How Much it is Effective in Treatment of Joint Stiffness in Hemophilia Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background: Hemophilia is a group of hereditary diseases in which the body’s ability to form blood clots and coagulate to prevent bleeding in the event of a ruptured vessel is impaired. Repeated bleeding over a long period eventually leads to chronic joint disease, which may manifest as arthritis, joint pain, or joint stiffness. This condition can lead to deterioration of quality of life and loss of organ function. Objective: This study, in the form of a systematic review, examines the role of physical therapy in affecting joint stiffness in hemophilia patients. Materials and Methods: PubMed, Embase, MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus databases were searched from inception to October 30, 2023. Mobility (timing and walking test) was included between the physiotherapy and control groups. Results: A total of 15 randomized controlled trial articles with 612 male hemophilia patients were included. In the comparison between the physiotherapy and control groups, the physiotherapy group experienced significantly reduced joint pain, increased joint range of motion, increased muscle strength, decreased Hemophilia Joint Health Score 2.1, and improved Six-Min Walk Test and Timed Up and Go Test performance or mobility. Comparisons show moderate- to high-quality evidence scores. Conclusions: Physiotherapy is effective in reducing pain, increasing joint range of motion, increasing joint health, and improving muscle strength and mobility in hemophilia patients.