Comparison of the Effect of Aquatic Exercise Therapy and Land-based Therapeutic Exercise on Knee Muscle's Strength and Quality of Life in Patients with Knee Joint Arthropathy due to Hemophilia

Decreasing muscle strength and the quality of life (QOL) are some major problems for hemophilic patients. The purpose of this study was to compare two treatment protocols, including land-based and water-based exercise therapy on muscle strength and QOL in patients with hemophilia for 8 weeks. In this experimental study, thirty-eight patients with hemophilia (type A) were randomly assigned into land-based exercise therapy, hydrotherapy and control groups. The participants in hydrotherapy group performed hamstring stretching and quadriceps strengthening exercises in water while the patients in land-based exercise therapy group followed the same exercises outside the water three days in a week for 8 weeks and the subjects in control group have their everyday life. The muscle strength and QOL were evaluated using hand held dynamometer and WOMAC questionnaire at base line and after interventions, respectively. The patients who completed the interventions had significant increase in hamstring (Mean±SD: hydrotherapy: post-test 17.7±4.8; exercise therapy: post-test 17.3±8.1; control: post-test 12.3±6.6) strength and quadriceps (Mean±SD: hydrotherapy: post-test 20.9±5.5; exercise therapy: post-test20.2±7.7; control: post-test (15.2±6.8) and improvement in QOL compared to subjects in control group (p<0.001). More significant (p<0.01) improvement in QOL (hydrotherapy: post-test 26.4±9.1; exercise therapy: post-test 26.4±9.1; control: post-test 43.4±6.4) was found in participants of WET group in comparison to those in LET group, although no significant (p>0.05) difference was detected between the WET and LET therapeutic programs in changes of quadriceps and hamstring muscle strength at baseline and after finishing the treatment protocols. Both interventions can improve quality of life and muscle strength of knee joint in patients with knee joint arthropathy due to hemophilia, although the influence of water-based exercise therapy program in improving QOL protocol is more than land-based exercise therapy method.