title: Efficacy of pulsed high-intensity laser therapy on pain, functional capacity, and gait in children with haemophilic arthropathy.
abstract: OBJECTIVE
  The aim of this study was to evaluate the effects of pulsed high-intensity laser therapy (HILT) on pain, functional capacity, and gait in children with haemophilia.
  
  
  METHODS
  Thirty children with haemophilia type A with ages ranging from 9 to 13 years were selected for this study. They were assigned randomly, into two equal treatment groups. The laser group received the traditional physical therapy programme plus active laser (total energy of 1500 J through three phases/3 sessions/week), whereas the placebo group received the same physical therapy programme plus placebo laser over three consecutive months. Baseline and post-treatment assessments used the visual analogue scale (VAS) to evaluate pain, a 6-min walk test (6MWT) to evaluate functional capacity, and the GAITRite®system to evaluate gait parameters.
  
  
  RESULTS
  Children in the laser group showed significant improvement in pain, functional capacity, and gait parameters compared to those in the placebo group (p < 0.05). Post-treatment functional capacity for the laser and placebo groups were 316.6 ± 35.27 and 288 ± 43.3 m, respectively.
  
  
  CONCLUSIONS
  HILT is an effective modality in reducing pain, increasing functional capacity, and improving gait performance in children with haemophilic arthropathy. Implications for Rehabilitation Haemophilic arthropathy due to recurrent joint bleeding leads to physical, psychological, and socioeconomic problems in children with haemophilia and reduces their quality of life. Early physiotherapeutic interventions help to prevent and treat the sequelae of recurrent haemarthrosis. High-intensity laser therapy has been introduced as non-invasive and an effective physiotherapy modality for rapid pain control, with consequent improvement in children's quality of life. High-intensity laser therapy should be used as an adjunct to exercise programme in the rehabilitation of children with haemophilic arthropathy.
authors.affiliation: a Department of Physical Therapy for Disturbance of Growth and Development in Children and its Surgery, Faculty of Physical Therapy , Cairo University , Giza , Egypt.
authors.forename: Shamekh Mohamed
authors.identifier: http://orcid.org/0000-0001-9690-1134
authors.initials: SM
authors.lastname: El-Shamy
authors.affiliation: b Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy , Cairo University , Giza , Egypt.
authors.forename: Ashraf Abdelaal Mohamed
authors.initials: AAM
authors.lastname: Abdelaal
mesh_terms: D000293:Adolescent; D002648:Child; D003131:Combined Modality Therapy; D005684:Gait; D006467:Hemophilia A / Q000503:physiopathology*; D006470:Hemorrhage / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007592:Joint Diseases / Q000503:physiopathology / Q000628:therapy*; D007719:Knee Joint / Q000503:physiopathology*; D053685:Laser Therapy; D008297:Male; D026741:Physical Therapy Modalities; D016037:Single-Blind Method; D064232:Visual Analog Scale; D000070857:Walk Test
keywords: HILT; functional capacity; gait; haemarthrosis; pain