Safety and efficacy of myofascial release therapy in the treatment of patients with hemophilic ankle arthropathy. Single-blind randomized clinical trial.

BACKGROUND: Hemophilia is characterized by degenerative joint damage. Patients with hemophilic arthropathy present joint damage, reduced range of motion, and decreased strength and functional capacity. Myofascial release therapy aims to decrease pain and improve tissue mobility and functionality. OBJECTIVES: To evaluate the safety and efficacy of myofascial release therapy in patients with hemophilic ankle arthropathy. METHOD: Single-blind randomized controlled trial. Fifty-eight adult patients with hemophilia were randomly allocated to the experimental group (myofascial release therapy with foam roller) or the control group (no intervention whatsoever). The daily home protocol of myofascial release therapy for the lower limbs using a foam roller lasted eight consecutive weeks. The primary variable was the safety of myofascial release therapy (weekly telephone follow-up). The secondary variables were pain intensity (visual analog scale), range of motion (goniometer), functional capacity (2-Minute Walk Test) and muscle strength (dynamometer), at baseline and at 8 and 10 weeks. RESULTS: During the experimental phase, none of the patients in the experimental group developed ankle hemarthrosis. There were statistically significant changes in time*group interaction in ankle dorsal flexion (F[1.75] = 10.72; p < .001), functional capacity (F[1.16] = 5.24; p = .009) and gastrocnemius strength (F[2] = 26.01; p < .001). The effect size of the changes after the intervention was medium-large in pain intensity (d = -1.77), functional capacity (d = 1.34) and gastrocnemius strength (d = 0.76). CONCLUSION: Myofascial release therapy is a safe form of physical therapy for patients with hemophilia. Myofascial release therapy can effectively complement prophylactic pharmacological treatment in patients with hemophilic arthropathy, improving range of motion in dorsal flexion, functional capacity and gastrocnemius strength.

Foam roller-based self-induced myofascial therapy in patients with hemophilic knee arthropathy: a multicenter, single-blind, randomized clinical study.

BACKGROUND: Hemophilia is a congenital coagulopathy characterized by degenerative joint damage. Self-induced myofascial therapy aims to decrease pain and improve tissue mobility, functionality and proprioception. AIM: The aim of this study was to evaluate the safety and efficacy of self-induced myofascial release in patients with hemophilic knee arthropathy. DESIGN: This is a randomized clinical study. SETTING: This study was carried out in different patient associations. POPULATION: Fifty-two patients with hemophilia were included in the study. METHODS: Patients were randomized to the experimental group (daily home protocol of foam roller-based self-induced myofascial therapy for 8 weeks) or the control group (no intervention). The variables were the frequency of hemarthrosis (self-reporting), pain intensity (visual analog scale), range of motion (goniometry) and muscle strength (dynamometry). All variables were evaluated at baseline, post-treatment and after a 10-week follow-up. RESULTS: The patients included in the experimental group showed significant improvements in terms of a decrease in frequency of hemarthrosis (mean difference [MD]=-0.61; 95% confidence interval [CI]: -0.81; -0.41) and pain intensity (MD=-0.33; 95% CI: -0.48, -0.18), increased range of motion (MD=0.88; 95% CI: 0.39; 1.37), strength in quadriceps (MD=0.88; 95% CI: 0.39; 1.37). (MD=12.39; 95% CI: 3.44; 21.34) and hamstrings (MD=7.85; 95% CI: 0.60; 15.11). There were intergroup differences in the frequency of hemarthrosis (F=14.51; P<0.001), pain intensity (F=9.14; P<0.001) and range of motion (F=13.58; P<0.001). CONCLUSIONS: Self-induced myofascial therapy can be an effective complementary technique in the treatment of patients with hemophilic arthropathy. Self-induced myofascial therapy can reduce the frequency of knee hemarthrosis in patients with hemophilia. This technique can improve pain intensity and range of motion in patients with hemophilic knee arthropathy. CLINICAL REHABILITATION IMPACT: Hemophilic knee arthropathy is characterized by chronic pain, decreased range of motion, and periarticular muscle atrophy. Foam roller-based self-induced myofascial therapy can reduce the frequency of hemarthrosis and pain intensity and improve range of motion in patients with hemophilic arthropathy. Foam roller-based self-induced myofascial therapy is safe and effective in the treatment of patients with hemophilia. The inclusion of self-induced myofascial therapy exercises in the approach to degenerative joint pathologies may be an effective and safe treatment option.

Self-Induced Myofascial Release in Patients with Hemophilic Ankle Arthropathy: A Pilot Observational Study.

Background: Hemophilic ankle arthropathy is manifested by degenerative functional alterations (reduced muscle strength, mobility, and proprioception) and chronic pain. Myofascial release techniques are used to treat soft tissue adhesions, relieve pain, and reduce tissue sensitivity. The aim was to evaluate the safety of self-induced myofascial release in patients with hemophilic ankle arthropathy and to assess possible changes in musculoskeletal variables. Methods: We recruited 20 patients with ankle hemophilic arthropathy. Patients carried out a daily self-induced myofascial release exercise program using a foam roller over a period of 8 weeks. The primary variable was the frequency of hemarthrosis (regular telephone follow-up). Secondary variables were pain intensity (visual analog scale), range of motion (goniometry), and functional capacity of the lower limbs (six-minute walk test). Three evaluations were performed: pre-treatment (T0), post-treatment (T1), and at 8 weeks follow-up (T2). Results: There was a lower, non-significant, association in the frequency of hemarthrosis between the experimental and follow-up periods, compared to the pre-study period (SE = 0.50; 95%CI: −1.67; 0.28). There were significant within-subject changes in intensity of pain (T0: 4.91; T1: 2.79; T2: 2.46; p < 0.001), plantar flexion (T0: 125.55; T1: 131.5; T2: 130.30; p = 0.01), and functionality of the lower limbs (T0: 173.06; T1: 184.85; T2: 178.39; p = 0.009). Conclusions: Self-induced myofascial release is safe in patients with hemophilic ankle arthropathy. A protocol based on self-induced myofascial release can lead to changes in pain intensity, range of ankle motion in plantar flexion, and functionality in hemophilic patients.

Safety and efficacy of a self-induced myofascial release protocol using a foam roller in patients with haemophilic knee arthropathy.

BACKGROUND: Haemophilic knee arthropathy presents functional and structural alterations and chronic pain. Self-induced myofascial release aims to treat fascial restrictions and improve functionality. AIM: This study investigated the safety and effectiveness of a self-induced myofascial release protocol in patients with haemophilic knee arthropathy. METHODS: Twenty-five patients with bilateral haemophilic knee arthropathy were recruited (n = 50 knees). The patients followed an intervention protocol, with daily exercises for 8 weeks. The dependent variables were: safety of the technique (periodic telephone monitoring), joint state (Haemophilia Joint Health Score), pain intensity (visual analogue scale), pressure pain threshold (pressure dynamometer), range of motion (universal goniometer) and hamstring flexibility (Fingertip-To-Floor test). The resulting values were measured at baseline (T0) and after the intervention (T1). Paired t-test compared the means between the assessments. Effect size was obtained using Cohen's d mean difference formula. The minimum detectable change of each variable was calculated. RESULTS: There were no cases of joint bleeding either during or after the procedure. The results showed improvements after the experimental period in joint state (Mean difference [MD]: 1.38; 95% confidence interval [95%CI]: .94;1.81), pain intensity (MD: 1.19; 95%CI: .70;1.67), pressure pain threshold (MD: -23.25; 95%CI: -26.25;-19.84), flexion (MD: -4.36; 95%CI: -5.70;-3.01), loss of extension (MD: 4.10; 95%CI: 3.01;5.18) and hamstring flexibility (MD: 3.54; 95%CI: 2.61;4.46). CONCLUSIONS: Myofascial self-release using a foam roller is safe in patients with haemophilic knee arthropathy. A myofascial self-release protocol can improve perceived pain, range of motion and knee joint status, as well as hamstring flexibility in patients with haemophilic knee arthropathy.

Uso de medicamentos en regímenes posológicos "off-label" / Drug use in off-label dosage regimes

No disponible

Construction of reference chromosome-scale pseudomolecules for potato: integrating the potato genome with genetic and physical maps.

The genome of potato, a major global food crop, was recently sequenced. The work presented here details the integration of the potato reference genome (DM) with a new sequence-tagged site marker-based linkage map and other physical and genetic maps of potato and the closely related species tomato. Primary anchoring of the DM genome assembly was accomplished by the use of a diploid segregating population, which was genotyped with several types of molecular genetic markers to construct a new ~936 cM linkage map comprising 2469 marker loci. In silico anchoring approaches used genetic and physical maps from the diploid potato genotype RH89-039-16 (RH) and tomato. This combined approach has allowed 951 superscaffolds to be ordered into pseudomolecules corresponding to the 12 potato chromosomes. These pseudomolecules represent 674 Mb (~93%) of the 723 Mb genome assembly and 37,482 (~96%) of the 39,031 predicted genes. The superscaffold order and orientation within the pseudomolecules are closely collinear with independently constructed high density linkage maps. Comparisons between marker distribution and physical location reveal regions of greater and lesser recombination, as well as regions exhibiting significant segregation distortion. The work presented here has led to a greatly improved ordering of the potato reference genome superscaffolds into chromosomal "pseudomolecules".

Genome-wide identification and mapping of NBS-encoding resistance genes in Solanum tuberosum group phureja.

The majority of disease resistance (R) genes identified to date in plants encode a nucleotide-binding site (NBS) and leucine-rich repeat (LRR) domain containing protein. Additional domains such as coiled-coil (CC) and TOLL/interleukin-1 receptor (TIR) domains can also be present. In the recently sequenced Solanum tuberosum group phureja genome we used HMM models and manual curation to annotate 435 NBS-encoding R gene homologs and 142 NBS-derived genes that lack the NBS domain. Highly similar homologs for most previously documented Solanaceae R genes were identified. A surprising ∼41% (179) of the 435 NBS-encoding genes are pseudogenes primarily caused by premature stop codons or frameshift mutations. Alignment of 81.80% of the 577 homologs to S. tuberosum group phureja pseudomolecules revealed non-random distribution of the R-genes; 362 of 470 genes were found in high density clusters on 11 chromosomes.

Genome sequence and analysis of the tuber crop potato.

Potato (Solanum tuberosum L.) is the world's most important non-grain food crop and is central to global food security. It is clonally propagated, highly heterozygous, autotetraploid, and suffers acute inbreeding depression. Here we use a homozygous doubled-monoploid potato clone to sequence and assemble 86% of the 844-megabase genome. We predict 39,031 protein-coding genes and present evidence for at least two genome duplication events indicative of a palaeopolyploid origin. As the first genome sequence of an asterid, the potato genome reveals 2,642 genes specific to this large angiosperm clade. We also sequenced a heterozygous diploid clone and show that gene presence/absence variants and other potentially deleterious mutations occur frequently and are a likely cause of inbreeding depression. Gene family expansion, tissue-specific expression and recruitment of genes to new pathways contributed to the evolution of tuber development. The potato genome sequence provides a platform for genetic improvement of this vital crop.