{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,30]],"date-time":"2025-11-30T05:15:47Z","timestamp":1764479747668,"version":"3.46.0"},"reference-count":43,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T00:00:00Z","timestamp":1764201600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Science and Higher Education in Poland","award":["MUG 01-30025\/0008359\/01\/MPK\/MPK\/2025"],"award-info":[{"award-number":["MUG 01-30025\/0008359\/01\/MPK\/MPK\/2025"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Hemophilia A and B are hereditary bleeding disorders that result in recurrent joint and muscle hemorrhages, leading to hemophilic arthropathy, muscle atrophy, and disability. Recent evidence suggests that physiotherapeutic interventions, including resistance training and manual therapy, may mitigate these effects, although comprehensive studies remain limited. This case series aimed to describe the outcomes of an eight-week physiotherapy program combining progressive resistance training and manual therapy in four adolescent boys (aged 11\u201317 years) with severe hemophilia. Methods: The program targeted joint function, muscle strength, ultrasound findings, and pain, with additional exploratory evaluation of neuroinflammatory and endothelial biomarkers: interleukin-18 (IL-18), C-C motif chemokine ligand 2 (CCL2), soluble intercellular adhesion molecule-1 (ssICAM-1), \u03b2-nerve growth factor (\u03b2-NGF), and soluble receptor for advanced glycation end-products (sRAGE). Results: After the intervention, Hemophilia Joint Health Score (HJHS) total scores decreased by 35\u201362%, indicating functional improvement, while muscle strength increased across most joints. No progression of arthropathy was observed on ultrasound (HEAD-US). IL-18 and ssICAM-1 levels decreased on average by 42% and 29%, respectively, whereas \u03b2-NGF and sRAGE increased by 39% and 11%, suggesting potential anti-inflammatory and neuroprotective responses. Conclusions: These descriptive findings indicate that individualized physiotherapy may serve as a supportive component of hemophilia care, while biomarker monitoring provides exploratory insight into treatment-related physiological responses.<\/jats:p>","DOI":"10.3390\/jcm14238419","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T11:19:51Z","timestamp":1764328791000},"page":"8419","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Eight-Week Resistance Training and Manual Therapy in Young Patients with Severe Hemophilia: A Case Series Evaluating Functional, Imaging, and Immunological Outcomes"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9399-3242","authenticated-orcid":false,"given":"Krystian","family":"Guzmann","sequence":"first","affiliation":[{"name":"Department of Immunobiology and Environment Microbiology, Faculty of Health Sciences, Medical University of Gdansk, 80-211 Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8663-3698","authenticated-orcid":false,"given":"Bartosz","family":"Wilczy\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Immunobiology and Environment Microbiology, Faculty of Health Sciences, Medical University of Gdansk, 80-211 Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7611-7617","authenticated-orcid":false,"given":"Marta","family":"Jaskulak","sequence":"additional","affiliation":[{"name":"Department of Immunobiology and Environment Microbiology, Faculty of Health Sciences, Medical University of Gdansk, 80-211 Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Rado\u0144-Proskura","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Haemathology and Oncology, Medical University of Gdansk, 80-211 Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arkadiusz","family":"Szarmach","sequence":"additional","affiliation":[{"name":"2nd Department of Radiology, Faculty of Health Sciences, Medical University of Gdansk, 80-211 Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrzej","family":"Mital","sequence":"additional","affiliation":[{"name":"Department of Hematology and Transplantology, Medical University of Gdansk, 80-211 Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2640-3791","authenticated-orcid":false,"given":"Katarzyna","family":"Zorena","sequence":"additional","affiliation":[{"name":"Department of Immunobiology and Environment Microbiology, Faculty of Health Sciences, Medical University of Gdansk, 80-211 Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,27]]},"reference":[{"key":"ref_1","first-page":"CD011180","article-title":"Exercise for Haemophilia","volume":"2016","author":"Strike","year":"2016","journal-title":"Cochrane Database Syst. 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