Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct 21;11(20):6216.
doi: 10.3390/jcm11206216.

Approach to Knee Arthropathy through 180-Degree Immersive VR Movement Visualization in Adult Patients with Severe Hemophilia: A Pilot Study

Roberto Ucero-Lozano  1 , Raúl Pérez-Llanes  2 , José Antonio López-Pina  3 , Rubén Cuesta-Barriuso  4
Affiliations

Approach to Knee Arthropathy through 180-Degree Immersive VR Movement Visualization in Adult Patients with Severe Hemophilia: A Pilot Study

Roberto Ucero-Lozano et al. J Clin Med. .

Abstract

(1) Background: Hemarthrosis is a typical clinical manifestation in patients with hemophilia. Its recurrence causes hemophilic arthropathy, characterized by chronic joint pain. Watching movement recorded from a first-person perspective and immersively can be effective in the management of chronic pain. The objective of this study was to evaluate the effectiveness of an immersive virtual reality intervention in improving the pain intensity, joint condition, muscle strength and range of motion in patients with hemophilic knee arthropathy. (2) Methods: Thirteen patients with hemophilic knee arthropathy were recruited. The patients wore virtual reality glasses and watched a flexion-extension movement of the knee on an immersive 180° video, recorded from a first-person perspective over a 28-day period. The primary variable was the pain intensity (visual analog scale). The secondary variables were the joint status (Hemophilia Joint Health Score), quadriceps and hamstring strength (dynamometry), and range of motion (goniometry). (3) Results: After the intervention period, statistically significant differences were observed in the intensity of the joint pain (Standard error [SE] = 19.31; 95% interval confidence [95%CI] = -1.05; -0.26), joint condition (SE = 18.68; 95%CI = -1.16; -0.52) and quadriceps strength (SE = 35.00; 95%CI = 2.53; 17.47). We found that 38.46% and 23.07% of the patients exhibited an improvement in their quadriceps muscle strength and joint condition above the minimum detectable change for both variables (8.21% and 1.79%, respectively). (4) Conclusions: One hundred and eighty degree immersive VR motion visualization can improve the intensity of joint pain in patients with hemophilic knee arthropathy. An intervention using immersive virtual reality can be an effective complementary approach to improve the joint condition and quadriceps strength in these patients.

Keywords: hemophilia; joint pain; knee; physiotherapy; virtual reality exposure therapy.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Patient completing the 180° immersive VR motion visualization intervention.
See this image and copyright information in PMC

References

    1. Pinto P., Paredes A.C., Almeida A. Pain Prevalence, Characteristics, and Impact Among People with Hemophilia: Findings from the First Portuguese Survey and Implications for Pain Management. Pain Med. Malden Mass. 2020;21:458–471. doi: 10.1093/pm/pny309. - DOI - PubMed
    1. Ucero-Lozano R., Pérez-Llanes R., López-Pina J.A., Cuesta-Barriuso R. One Session Effects of Knee Motion Visualization Using Immersive Virtual Reality in Patients with Hemophilic Arthropathy. J. Clin. Med. 2021;10:4725. doi: 10.3390/jcm10204725. - DOI - PMC - PubMed
    1. Soucie J.M., Cianfrini C., Janco R.L., Kulkarni R., Hambleton J., Evatt B., Forsyth A., Geraghty S., Hoots K., Abshire T., et al. Joint range-of-motion limitations among young males with hemophilia: Prevalence and risk factors. Blood. 2004;103:2467–2473. doi: 10.1182/blood-2003-05-1457. - DOI - PubMed
    1. Manco-Johnson M.J., Abshire T.C., Shapiro A.D., Riske B., Hacker M.R., Kilcoyne R., Ingram J.D., Manco-Johnson M.L., Funk S., Jacobson L., et al. Prophylaxis versus Episodic Treatment to Prevent Joint Disease in Boys with Severe Hemophilia. N. Engl. J. Med. 2007;357:535–544. doi: 10.1056/NEJMoa067659. - DOI - PubMed
    1. St-Louis J., Abad A., Funk S., Tilak M., Classey S., Zourikian N., McLaughlin P., Lobet S., Hernandez G., Akins S., et al. The Hemophilia Joint Health Score version 2.1 Validation in Adult Patients Study: A multicenter international study. Res. Pract. Thromb. Haemost. 2022;6:e12690. doi: 10.1002/rth2.12690. - DOI - PMC - PubMed

Grants and funding

LinkOut - more resources