{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:59:54Z","timestamp":1787839194420,"version":"build-2784847793"},"reference-count":43,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T00:00:00Z","timestamp":1738886400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T00:00:00Z","timestamp":1738886400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Haemophilia"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Haemophilic ankle arthropathy is characterized by chronic pain, loss of strength and proprioception, decreased range of motion (ROM) and impaired functionality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the safety and efficacy of a manual therapy protocol based on joint and myofascial techniques in patients with haemophilic ankle arthropathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A randomized, single\u2010blind pilot study. Twenty\u2010four patients with haemophilia were randomized to the experimental (manual therapy) and control (no intervention) groups. The intervention lasted for 3 weeks, with one 50\u2010min weekly session. Techniques used: active\u2010passive joint mobilization, articulatory technique, joint decompression and high\u2010speed and short\u2010stroke manipulation, and sustained myofascial induction techniques. The study variables were safety of the intervention (number of hemarthroses), joint pain intensity (visual analogue scale), pressure pain threshold (pressure algometer), range of ankle motion (Leg Motion) and joint condition (Haemophilia Joint Health Score).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      None of the patients developed ankle hemarthrosis during the intervention. After the intervention there were intergroup differences in the variables pain intensity (MD = \u22120.45;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), ROM (MD = 0.19;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.003), joint condition (MD = 0.04;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.03) and pressure pain threshold in the internal malleolus (MD = 1.36;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.01). For the interaction\n                      <jats:italic>time*group<\/jats:italic>\n                      after the follow\u2010up period, there were statistically significant differences in pain intensity (\n                      <jats:italic>F<\/jats:italic>\n                      = 6.94;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.01) and dorsal flexion (\n                      <jats:italic>F<\/jats:italic>\n                      = 3.36;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.04) of the ankle.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Manual therapy based on joint and myofascial techniques is safe in haemophilia patients. A protocol implementing joint and myofascial techniques having the dosage and safety parameters established in this study can improve the intensity of pain and dorsal flexion of the ankle in these patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov identifier: NCT05549843<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hae.70002","type":"journal-article","created":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T05:47:44Z","timestamp":1738907264000},"page":"295-303","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Joint and Myofascial Manual Therapy Techniques in Haemophilic Ankle Arthropathy: A Randomized Pilot Study"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-7134-8246","authenticated-orcid":false,"given":"Carlos","family":"Truque\u2010D\u00edaz","sequence":"first","affiliation":[{"name":"Faculty of Physiotherapy Podiatry and Occupational Therapy Catholic University San Antonio\u2010UCAM  Murcia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8434-8308","authenticated-orcid":false,"given":"Javier","family":"Mero\u00f1o\u2010Gallut","sequence":"additional","affiliation":[{"name":"T\u00fa. Bienestar 360 Physiotherapy and Medical Center  San Javier\u2010Murcia Spain"},{"name":"InHeFis Research Group Instituto Asturiano de Investigaci\u00f3n Sanitaria (ISPA)  Oviedo Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4276-6982","authenticated-orcid":false,"given":"Rub\u00e9n","family":"Cuesta\u2010Barriuso","sequence":"additional","affiliation":[{"name":"InHeFis Research Group Instituto Asturiano de Investigaci\u00f3n Sanitaria (ISPA)  Oviedo Spain"},{"name":"Department of Surgery and Medical\u2010Surgical Specialties University of Oviedo  Oviedo Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5050-1845","authenticated-orcid":false,"given":"Ra\u00fal","family":"P\u00e9rez\u2010Llanes","sequence":"additional","affiliation":[{"name":"InHeFis Research Group Instituto Asturiano de Investigaci\u00f3n Sanitaria (ISPA)  Oviedo Spain"},{"name":"Department of Physiotherapy 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