本体感觉训练对儿童血友病患者下肢靶关节出血频率的影响

目的:研究本体感觉训练对中重型儿童血友病患者下肢靶关节出血频率的影响。方法:本研究为前瞻性随机对照临床研究,将40例中重型血友病患儿随机分成2组,分别为单纯预防性低剂量凝血因子替代组和预防性低剂量凝血因子替代+本体感觉训练组,每组疗程8周。观察比较治疗期间、治疗结束1个月、3个月时两组出血频率,并对随访3个月时两组出血频率分别与治疗前进行比较。结果:治疗期间和治疗后1个月本体感觉训练组出血频率较对照组显著减少,随访3个月时与对照组比较差异无显著性,但分别与治疗前相比,差异均有显著性。结论:本体感觉训练在预防血友病儿童再次出血和减少出血次数方面具有重要作用,但是,治疗停止后随着时间的推移差异逐渐减弱消失。因此,儿童血友病患者应该坚持进行长期的、规律性的治疗性训练,从而保持本体感觉功能,预防和减少下肢靶关节的出血。

Affects of proprioception training on bleeding frequency in target joints of low extremities in children with moderate-severe hemophilia

Abstract Objective: To study if proprioception training will reduce bleeding episodes in target joints of low extremities in children with moderate-severe hemophilia. Method: Forty moderate-severe hemophilia children were enrolled in this prospective randomized clinical trial and divided into group A and B. Children in group A and B were prescribed secondary prophylaxis with low dose factor concentrate replacement for 8 weeks, and group B received proprioception training for 8 weeks additionally. Bleeding episodes in target joints of low extremities were observed during treatment, 1 month and 3 months after treatment, respectively. Result: During treatment and follow up 1 month, bleeding episodes in target joints of low extremities in group B were less than group A statistically, while in follow up 3 months, there was no difference between two groups statistically. Conclusion: Proprioception training will prevent and reduce target joints bleeding episodes, but this effect will recede gradually after training stopped. So in hemophilia patients especially children, individualized, long-term and regular therapeutic exercises should have to keep to improve proprioception function in order to prevent and reduce bleeding episodes in target joints.