Foam roller-based self-induced myofascial therapy in patients with hemophilic knee arthropathy: a multicenter, single-blind, randomized clinical study
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. The aim of this study was to evaluate the safety and efficacy of self-induced myofascial release in...
Saved in:
Published in | European journal of physical and rehabilitation medicine Vol. 59; no. 6; pp. 763 - 771 |
---|---|
Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
Italy
Edizioni Minerva Medica
01.12.2023
|
Online Access | Get full text |
Cover
Loading…
Abstract | 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.
The aim of this study was to evaluate the safety and efficacy of self-induced myofascial release in patients with hemophilic knee arthropathy.
This is a randomized clinical study.
This study was carried out in different patient associations.
Fifty-two patients with hemophilia were included in the study.
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.
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).
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.
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. |
---|---|
AbstractList | 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.
The aim of this study was to evaluate the safety and efficacy of self-induced myofascial release in patients with hemophilic knee arthropathy.
This is a randomized clinical study.
This study was carried out in different patient associations.
Fifty-two patients with hemophilia were included in the study.
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.
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).
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.
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. |
Author | Donoso-Úbeda, Elena Meroño-Gallut, Javier Cuesta-Barriuso, Rubén Ucero-Lozano, Roberto Pérez-Llanes, Raúl |
Author_xml | – sequence: 1 givenname: Elena surname: Donoso-Úbeda fullname: Donoso-Úbeda, Elena organization: InHeFis Research Group, Instituto Asturiano de Investigación Sanitaria, Oviedo, Spain – sequence: 2 givenname: Raúl surname: Pérez-Llanes fullname: Pérez-Llanes, Raúl organization: InHeFis Research Group, Instituto Asturiano de Investigación Sanitaria, Oviedo, Spain – sequence: 3 givenname: Javier surname: Meroño-Gallut fullname: Meroño-Gallut, Javier organization: Service of Physiotherapy, Tu Bienestar 360°, San Javier, Spain – sequence: 4 givenname: Roberto surname: Ucero-Lozano fullname: Ucero-Lozano, Roberto organization: Department of Physiotherapy, European University of Madrid, Madrid, Spain – sequence: 5 givenname: Rubén surname: Cuesta-Barriuso fullname: Cuesta-Barriuso, Rubén email: cuestaruben@uniovi.es organization: Department of Surgery and Medical-Surgical Specialties, University of Oviedo, Oviedo, Spain |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/37869759$$D View this record in MEDLINE/PubMed |
BookMark | eNpVUcFu3CAURFGiZpP0FyI-IE4x2GD3UlWrJqkUKYckZ4TheU2KwQJvI_dD-r0lu-mqFYcHw5sZHnOGjn3wgNBlSa4pE4x_eixbwYqWNCID10S0VVWwI7R6h9v6-LBvxCk6S-mFEM7Khn9Ap0w0vBV1u0K_b4IacQzOQSw6lcDgBK4vrDdbnQ_jEnqVtFUOzwNENS3Yejyp2YKfE36184AHGMM0WGc1_uEBsIrzEEPuGZbPWOFx62arczvEK5ys3zgoOpcNrnBU3oTR_spGOiNWZ5s0b81ygU565RJ8fK_n6Pnm29P6rrh_uP2-_npfaMbpXEDbt6RqKqq5hp6IroM8Iq2p0rqmdS8IMSIvU4uyNpoKWnUdZ1D1hnWmouwcfdnrTttuBPP2yqicnKIdVVxkUFb-f-PtIDfhpyzzj9eCi6zA9wo6hpQi9AdySeQuKrmLSr7lkAG5i0qyTLz81_pA-5sN-wMBQ5dk |
Cites_doi | 10.1371/journal.pone.0248952 10.1111/hae.14623 10.1016/j.jbmt.2019.05.002 10.1111/hae.14498 10.1136/bjsm.2003.006114 10.1111/j.1365-2516.2008.01732.x 10.1371/journal.pone.0140822 10.1111/hae.12526 10.1142/S1013702521500025 10.1111/hae.14031 10.12968/ijtr.2014.21.12.569 10.1123/jsr.2018-0261 10.1111/hae.14593 10.26603/ijspt20200579 10.1111/hae.12197 10.3390/sports9120159 10.1016/j.jpain.2007.09.005 10.1111/jth.15444 10.2196/15612 10.1016/j.math.2015.01.004 10.21037/atm-21-747 10.1111/j.1365-2516.2012.02808.x 10.3390/ijerph18010075 10.1111/j.1538-7836.2010.03962.x 10.2147/JBM.S343924 10.1093/ptj/63.10.1611 10.4085/1062-6050-459-18 10.1053/eujp.2001.0313 10.3390/jcm10132822 10.1249/MSS.0b013e3182a123db 10.1080/09593985.2020.1812138 10.1519/JPT.0000000000000028 10.1136/jnnp.42.7.600 10.1016/j.jclinepi.2004.02.007 10.1519/JSC.0b013e31825c2bc1 10.1186/s12891-018-1934-9 10.4103/abr.abr_244_18 10.1186/1477-7525-4-54 10.1177/001316447303300111 10.1186/s13244-021-01050-1 10.3390/healthcare9060702 |
ContentType | Journal Article |
Copyright | 2023 THE AUTHORS |
Copyright_xml | – notice: 2023 THE AUTHORS |
DBID | NPM AAYXX CITATION 5PM |
DOI | 10.23736/S1973-9087.23.07944-3 |
DatabaseName | PubMed CrossRef PubMed Central (Full Participant titles) |
DatabaseTitle | PubMed CrossRef |
DatabaseTitleList | PubMed |
Database_xml | – sequence: 1 dbid: NPM name: PubMed url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database |
DeliveryMethod | fulltext_linktorsrc |
EISSN | 1973-9095 |
EndPage | 771 |
ExternalDocumentID | 10_23736_S1973_9087_23_07944_3 37869759 |
Genre | Journal Article |
GrantInformation_xml | – fundername: Baxalta GmbH grantid: IIR-ES-002614 |
GroupedDBID | NPM --- 29G 2WC 3V. 53G 5GY 7X7 88E 88I 8AF 8AO 8FI 8FJ 8R4 8R5 AAFWJ AAYXX ABUWG ACGOD ADBBV AENEX AFKRA AHMBA ALMA_UNASSIGNED_HOLDINGS AQUVI AZQEC BAWUL BENPR BPHCQ BVXVI CCPQU CITATION DIK DWQXO EBS EJD F5P FRP FYUFA GNUQQ GROUPED_DOAJ HCIFZ HMCUK M0T M1P M2P M2Q ODF PQQKQ PROAC PSQYO Q2X RPM S0X UKHRP 5PM |
ID | FETCH-LOGICAL-c362t-e9f904842c6cef07bbe631252acc525f700d7d7dd5715dc2724bb63e4fd3bd423 |
IEDL.DBID | RPM |
ISSN | 1973-9087 |
IngestDate | Tue Sep 17 21:30:01 EDT 2024 Fri Aug 23 00:47:08 EDT 2024 Wed Oct 23 10:15:24 EDT 2024 |
IsDoiOpenAccess | true |
IsOpenAccess | true |
IsPeerReviewed | true |
IsScholarly | true |
Issue | 6 |
Language | English |
License | This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (CC BY-NC-ND) 4.0 License. |
LinkModel | DirectLink |
MergedId | FETCHMERGED-LOGICAL-c362t-e9f904842c6cef07bbe631252acc525f700d7d7dd5715dc2724bb63e4fd3bd423 |
Notes | Authors’ contributions: Elena Donoso-Úbeda, Raúl Pérez-Llanes, Javier Meroño-Gallut, Roberto Ucero-Lozano and Rubén Cuesta-Barriuso contributed equally to the manuscript, Elena Donoso-Úbeda, Javier Meroño-Gallut, Roberto Ucero-Lozano and Rubén Cuesta-Barriuso have given substantial contributions to study conception and design, Roberto Ucero-Lozano and Rubén Cuesta-Barriuso to data acquisition, analysis and interpretation, Elena Donoso-Úbeda, Raúl Pérez-Llanes, Javier Meroño-Gallut, Roberto Ucero-Lozano and Rubén Cuesta-Barriuso to manuscript writing, Elena Donoso-Úbeda to manuscript critical revision. All authors read and approved the final version of the manuscript. |
OpenAccessLink | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10795767/ |
PMID | 37869759 |
PageCount | 9 |
ParticipantIDs | pubmedcentral_primary_oai_pubmedcentral_nih_gov_10795767 crossref_primary_10_23736_S1973_9087_23_07944_3 pubmed_primary_37869759 |
PublicationCentury | 2000 |
PublicationDate | 2023-12-01 |
PublicationDateYYYYMMDD | 2023-12-01 |
PublicationDate_xml | – month: 12 year: 2023 text: 2023-12-01 day: 01 |
PublicationDecade | 2020 |
PublicationPlace | Italy |
PublicationPlace_xml | – name: Italy |
PublicationTitle | European journal of physical and rehabilitation medicine |
PublicationTitleAlternate | Eur J Phys Rehabil Med |
PublicationYear | 2023 |
Publisher | Edizioni Minerva Medica |
Publisher_xml | – name: Edizioni Minerva Medica |
References | Hawksley H (10.23736/S1973-9087.23.07944-3_ref022) 2000; 15 10.23736/S1973-9087.23.07944-3_ref009 10.23736/S1973-9087.23.07944-3_ref008 10.23736/S1973-9087.23.07944-3_ref007 10.23736/S1973-9087.23.07944-3_ref029 10.23736/S1973-9087.23.07944-3_ref006 10.23736/S1973-9087.23.07944-3_ref028 10.23736/S1973-9087.23.07944-3_ref005 10.23736/S1973-9087.23.07944-3_ref027 10.23736/S1973-9087.23.07944-3_ref004 10.23736/S1973-9087.23.07944-3_ref026 10.23736/S1973-9087.23.07944-3_ref003 10.23736/S1973-9087.23.07944-3_ref025 10.23736/S1973-9087.23.07944-3_ref024 10.23736/S1973-9087.23.07944-3_ref046 10.23736/S1973-9087.23.07944-3_ref001 10.23736/S1973-9087.23.07944-3_ref023 10.23736/S1973-9087.23.07944-3_ref045 10.23736/S1973-9087.23.07944-3_ref044 10.23736/S1973-9087.23.07944-3_ref021 10.23736/S1973-9087.23.07944-3_ref043 10.23736/S1973-9087.23.07944-3_ref020 10.23736/S1973-9087.23.07944-3_ref042 10.23736/S1973-9087.23.07944-3_ref041 Cheatham SW (10.23736/S1973-9087.23.07944-3_ref036) 2017; 12 10.23736/S1973-9087.23.07944-3_ref040 10.23736/S1973-9087.23.07944-3_ref019 10.23736/S1973-9087.23.07944-3_ref018 10.23736/S1973-9087.23.07944-3_ref017 Blanca MJ (10.23736/S1973-9087.23.07944-3_ref031) 2017; 29 10.23736/S1973-9087.23.07944-3_ref039 10.23736/S1973-9087.23.07944-3_ref016 10.23736/S1973-9087.23.07944-3_ref038 10.23736/S1973-9087.23.07944-3_ref015 10.23736/S1973-9087.23.07944-3_ref037 10.23736/S1973-9087.23.07944-3_ref014 10.23736/S1973-9087.23.07944-3_ref013 10.23736/S1973-9087.23.07944-3_ref035 10.23736/S1973-9087.23.07944-3_ref012 10.23736/S1973-9087.23.07944-3_ref034 10.23736/S1973-9087.23.07944-3_ref011 10.23736/S1973-9087.23.07944-3_ref033 10.23736/S1973-9087.23.07944-3_ref010 10.23736/S1973-9087.23.07944-3_ref032 10.23736/S1973-9087.23.07944-3_ref030 Benson G (10.23736/S1973-9087.23.07944-3_ref002) 2018; 16 |
References_xml | – ident: 10.23736/S1973-9087.23.07944-3_ref003 doi: 10.1371/journal.pone.0248952 – volume: 15 start-page: 593 year: 2000 ident: 10.23736/S1973-9087.23.07944-3_ref022 article-title: Pain assessment using a visual analogue scale publication-title: Prof Nurse contributor: fullname: Hawksley H – ident: 10.23736/S1973-9087.23.07944-3_ref007 doi: 10.1111/hae.14623 – ident: 10.23736/S1973-9087.23.07944-3_ref016 doi: 10.1016/j.jbmt.2019.05.002 – volume: 29 start-page: 552 year: 2017 ident: 10.23736/S1973-9087.23.07944-3_ref031 article-title: Non-normal data: is ANOVA still a valid option? publication-title: Psicothema contributor: fullname: Blanca MJ – ident: 10.23736/S1973-9087.23.07944-3_ref019 doi: 10.1111/hae.14498 – volume: 16 start-page: 535 year: 2018 ident: 10.23736/S1973-9087.23.07944-3_ref002 article-title: Diagnosis and care of patients with mild haemophilia: practical recommendations for clinical management publication-title: Blood Transfus contributor: fullname: Benson G – ident: 10.23736/S1973-9087.23.07944-3_ref024 doi: 10.1136/bjsm.2003.006114 – ident: 10.23736/S1973-9087.23.07944-3_ref039 doi: 10.1111/j.1365-2516.2008.01732.x – ident: 10.23736/S1973-9087.23.07944-3_ref027 doi: 10.1371/journal.pone.0140822 – ident: 10.23736/S1973-9087.23.07944-3_ref035 doi: 10.1111/hae.12526 – ident: 10.23736/S1973-9087.23.07944-3_ref018 doi: 10.1142/S1013702521500025 – ident: 10.23736/S1973-9087.23.07944-3_ref030 doi: 10.1111/hae.14031 – ident: 10.23736/S1973-9087.23.07944-3_ref038 doi: 10.12968/ijtr.2014.21.12.569 – ident: 10.23736/S1973-9087.23.07944-3_ref041 doi: 10.1123/jsr.2018-0261 – ident: 10.23736/S1973-9087.23.07944-3_ref008 doi: 10.1111/hae.14593 – ident: 10.23736/S1973-9087.23.07944-3_ref015 doi: 10.26603/ijspt20200579 – ident: 10.23736/S1973-9087.23.07944-3_ref020 doi: 10.1111/hae.12197 – ident: 10.23736/S1973-9087.23.07944-3_ref046 doi: 10.3390/sports9120159 – ident: 10.23736/S1973-9087.23.07944-3_ref023 doi: 10.1016/j.jpain.2007.09.005 – volume: 12 start-page: 242 year: 2017 ident: 10.23736/S1973-9087.23.07944-3_ref036 article-title: Comparison of video-guided, live instructed, and self-guided foam roll interventions on knee joint range of motion and pressure pain threshold: a randomized controlled trial publication-title: Int J Sports Phys Ther contributor: fullname: Cheatham SW – ident: 10.23736/S1973-9087.23.07944-3_ref009 doi: 10.1111/jth.15444 – ident: 10.23736/S1973-9087.23.07944-3_ref021 doi: 10.2196/15612 – ident: 10.23736/S1973-9087.23.07944-3_ref026 doi: 10.1016/j.math.2015.01.004 – ident: 10.23736/S1973-9087.23.07944-3_ref001 doi: 10.21037/atm-21-747 – ident: 10.23736/S1973-9087.23.07944-3_ref011 doi: 10.1111/j.1365-2516.2012.02808.x – ident: 10.23736/S1973-9087.23.07944-3_ref045 doi: 10.3390/ijerph18010075 – ident: 10.23736/S1973-9087.23.07944-3_ref043 doi: 10.1111/j.1538-7836.2010.03962.x – ident: 10.23736/S1973-9087.23.07944-3_ref006 doi: 10.2147/JBM.S343924 – ident: 10.23736/S1973-9087.23.07944-3_ref025 doi: 10.1093/ptj/63.10.1611 – ident: 10.23736/S1973-9087.23.07944-3_ref044 doi: 10.4085/1062-6050-459-18 – ident: 10.23736/S1973-9087.23.07944-3_ref029 doi: 10.1053/eujp.2001.0313 – ident: 10.23736/S1973-9087.23.07944-3_ref005 doi: 10.3390/jcm10132822 – ident: 10.23736/S1973-9087.23.07944-3_ref037 doi: 10.1249/MSS.0b013e3182a123db – ident: 10.23736/S1973-9087.23.07944-3_ref017 doi: 10.1080/09593985.2020.1812138 – ident: 10.23736/S1973-9087.23.07944-3_ref028 doi: 10.1519/JPT.0000000000000028 – ident: 10.23736/S1973-9087.23.07944-3_ref042 doi: 10.1136/jnnp.42.7.600 – ident: 10.23736/S1973-9087.23.07944-3_ref033 doi: 10.1016/j.jclinepi.2004.02.007 – ident: 10.23736/S1973-9087.23.07944-3_ref040 doi: 10.1519/JSC.0b013e31825c2bc1 – ident: 10.23736/S1973-9087.23.07944-3_ref012 doi: 10.1186/s12891-018-1934-9 – ident: 10.23736/S1973-9087.23.07944-3_ref013 doi: 10.4103/abr.abr_244_18 – ident: 10.23736/S1973-9087.23.07944-3_ref034 doi: 10.1186/1477-7525-4-54 – ident: 10.23736/S1973-9087.23.07944-3_ref032 doi: 10.1177/001316447303300111 – ident: 10.23736/S1973-9087.23.07944-3_ref004 doi: 10.1186/s13244-021-01050-1 – ident: 10.23736/S1973-9087.23.07944-3_ref014 – ident: 10.23736/S1973-9087.23.07944-3_ref010 doi: 10.3390/healthcare9060702 |
SSID | ssj0063186 |
Score | 2.3842938 |
Snippet | Hemophilia is a congenital coagulopathy characterized by degenerative joint damage. Self-induced myofascial therapy aims to decrease pain and improve tissue... |
SourceID | pubmedcentral crossref pubmed |
SourceType | Open Access Repository Aggregation Database Index Database |
StartPage | 763 |
Title | Foam roller-based self-induced myofascial therapy in patients with hemophilic knee arthropathy: a multicenter, single-blind, randomized clinical study |
URI | https://www.ncbi.nlm.nih.gov/pubmed/37869759 https://pubmed.ncbi.nlm.nih.gov/PMC10795767 |
Volume | 59 |
hasFullText | 1 |
inHoldings | 1 |
isFullTextHit | |
isPrint | |
link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1La9tAEF6SnHopDX25TcMcesxayr7VWwk1oeAQaAO5Ce2LmFqSsd2D-0P6ezu7skx8LQIdRitpmW-keTAPQj7roJnzWtNGSkaFKT21jHsavTMeNZaqcuhifqduH8T3R_l4QtRYC5OT9p1dTLtlO-0WTzm3ctW6YswTK-7nN-iyVGgn6-KUnGrORx99-P8qlNJcU1RpTqvS6KEumHHNVfHjQEXCFB8jBE2jdLg2qtKpYekz7XRQScfpks_0z-wVebk3HOHrsMFzchK61-TvrG9aWCfnf02TQvKwCctI0dFGyDy0uz42mxQVh6HQageLDva9VDeQgrDwFNp-lcIqDn51IQCyII1OQMtw9wUayBmHaU9hfQUpsLAM1KJt6q8A1Zzv28UffNFYYAm5Xe0b8jD79vPmlu4nLVCHCmxLQxUr_JQFc8qFWGprA7KRSdY4J5mMuiy9xsNLfS29Y5oJaxUPInpuPVpkb8lZ13fhPQHnG2UYl5GhMXjNgjFeCh-bYIUzUeoJKUYO16uhoUaNjkiGp87w1AkeJNQZnppPyLuB_4f1I1oTYo6QOSxIPbOPr6Ao5d7Zo-h8-P9bP5IXaeb8kNNyQc6269_hE1omW3uZPXo8393PL7NQ_gPnZ-cJ |
link.rule.ids | 230,315,733,786,790,870,891,27955,27956,53825,53827 |
linkProvider | National Library of Medicine |
linkToHtml | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV3JbtswECXS9NBeuqCbu_LQYygp3NVbEdRw2zgo0ATNTRA3xIglGbZzcD6k39shZRlxby10oyiJxBvxzQxmQeij8opapxSphaCE68IRQ5kjwVntgLFkmVwX0zM5ueDfLsXlAZJDLkwK2rdmlrXzJmtnVym2ctHYfIgTy39MT8BkKUFPVvk9dB9-WCoGK70_gSXIacoqKhUjZaFVnxlMmWIy_7kbhYEMXsQ5ic10mNKyVLFk6R1-2pHSfsDkHQYaP0a_hrX3gSfX2c3aZPb2r7KO_765J-jRVinFn_v7T9GBb5-h3-OubvAyOhaWJJKdwys_DwSMeBAHh5tNF-pV9LjjPolrg2ct3tZpXeHo4MVXvukW0WVj8XXrPYYVxLYMoHVuPuEap2jGuFu_PMLRaTH3xIDe644wUKjrmtktfGhI3sSpFO5zdDH-cn4yIdsuDsQCOa6JL0MJxwSnVlofCmWMB4CooLW1goqgisIpuJxQx8JZqig3RjLPg2PGgbb3Ah22XetfIWxdLTVlIlBQNI-p19oJ7kLtDbc6CDVC-YBdteiLdVRg5CTgqwR8FYGHgSoBX7ERetkju5s_yMEI6T3MdxNiPe79O4Bkqss9IPf6_x_9gB5Mzqen1enXs-9v0MPY276PnXmLDtfLG_8ONKC1eZ_E_Q_nvAdI |
linkToPdf | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1La9wwEBZtCqWXPugj26cOPUa2I0uW3FtJu6SPhEAbCPRgLI1ElqztZXdz2PyQ_t6OZHvJ9hh8k2Vb4htrHnwzQ8hH5RS3oBSrpeRM6AyY4TkwD1YDaqyijKGLk9Pi-Fx8v5AXA6tyNdAqW2tmSTtvknZ2GbmVi8amI08sPTs5QpelRDtZpQvw6X3yAH9arkZPvT-FC5TVmFlUqpyVmVZ9djDPVV6kv7ajOJDgy4RgoaFOrnRRqlC29JaO2iqmXdLkLS00fUL-jOvvySdXyfXaJPbmv9KOd9vgU_J4ME7p537OM3LPtc_J32lXN3QZAgxLFpQe0JWbe4bOPIoF0GbT-XoVIu-0T-ba0FlLh3qtKxoCvfTSNd0ihG4svWqdo7iK0J4Brc_NJ1rTyGoMO3bLAxqCF3PHDNq_cEBRlULXzG7wQ2MSJ40lcV-Q8-nX30fHbOjmwCwqyTVzpS_xuBDcFtb5TBnjECQueW2t5NKrLAOFF0h1KMFyxYUxRe6Eh9wAWn0vyV7btW6fUAt1oXkuPUeD85A7rUEK8LUzwmov1YSkI37Voi_aUaGzE8GvIvhVAB8Hqgh-lU_Iqx7d7fxRFiZE7-C-nRDqcu_eQTRjfe4Rvdd3f_QDeXj2ZVr9_Hb64w15FFrc9xSat2Rvvbx279AQWpv3UeL_ARbcCcg |
openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Foam+roller-based+self-induced+myofascial+therapy+in+patients+with+hemophilic+knee+arthropathy%3A+a+multicenter%2C+single-blind%2C+randomized+clinical+study&rft.jtitle=European+journal+of+physical+and+rehabilitation+medicine&rft.au=DONOSO-%C3%9ABEDA%2C+Elena&rft.au=P%C3%89REZ-LLANES%2C+Ra%C3%BAl&rft.au=MERO%C3%91O-GALLUT%2C+Javier&rft.au=UCERO-LOZANO%2C+Roberto&rft.date=2023-12-01&rft.issn=1973-9087&rft.eissn=1973-9095&rft.volume=59&rft.issue=6&rft_id=info:doi/10.23736%2FS1973-9087.23.07944-3&rft.externalDBID=n%2Fa&rft.externalDocID=10_23736_S1973_9087_23_07944_3 |
thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1973-9087&client=summon |
thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1973-9087&client=summon |
thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1973-9087&client=summon |