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...

Full description

Saved in:
Bibliographic Details
Published inEuropean journal of physical and rehabilitation medicine Vol. 59; no. 6; pp. 763 - 771
Main Authors Donoso-Úbeda, Elena, Pérez-Llanes, Raúl, Meroño-Gallut, Javier, Ucero-Lozano, Roberto, Cuesta-Barriuso, Rubén
Format Journal Article
LanguageEnglish
Published Italy Edizioni Minerva Medica 01.12.2023
Online AccessGet 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