Effects of Plyometric-Based Hydro-Kinesiotherapy on Pain, Muscle Strength, Postural Stability, and Functional Performance in Children with Hemophilic Knee Arthropathy: A Randomized Trial

Aim: To explore how plyometric-based hydro-kinesiotherapy (Plyo-HKT) would affect pain, muscle strength, postural stability, and functional performance in a convenience sample of children with hemophilic knee arthropathy (HKA). Methods: Forty-eight children with HKA (age: 8–16 years) were randomly allocated to the Plyo-HKT group (n = 24; underwent the Plyo-HKT for 45 min, twice/week over 12 wk in succession) or the comparison group (n = 24; performed the standard exercise rehabilitation at an equivalent frequency and duration). Pain, peak concentric torque of quadriceps and hamstring (produced at two angular velocities: 120 and 180 ^o/sec), dynamic limits of postural stability (DLPS), and functional performance [Functional Independence Score in Hemophilia (FISH) and 6-Minute Walk Test (6-MWT)] were assessed pre- and post-intervention. Results: In contrast with the comparison group, the Plyo-HKT group achieved more favorable pre-to-post changes in pain (p =.028, η²_p = 0.10), peak torque of quadriceps [120°/sec (p =.007, η²_P = 0.15); 180°/sec (p =.011, η²_P = 0.13)] and hamstring [120°/sec (p =.024, η²_P = 0.11); 180°/sec (p =.036, η²_P = 0.09)], DLPS_directional [forward (p =.007, η²_P = 0.15); backward (p =.013, η²_P = 0.12); affected side (p =.008, η²_P = 0.14); non-affected side (p =.002, η²_P = 0.20)], DLPS_overall (p <.001, η²_P = 0.32), and functional performance [FISH (p <.001, η²_p = 0.26); 6-MWT (p =.002, η²_p = 0.19)]. Conclusion: Plyo-HKT is likely helpful for reducing pain, improving strength, enhancing postural stability, and boosting functional capabilities in children with HKA. Physical rehabilitation practitioners should, therefore, consider this intervention strategy.