Role of Physiotherapy in Haemophilia-an Evidence Based Practice

Haemophilia is hereditary bleeding disorder due to absence or deficiency of clotting factors in the blood. Haemophilia is characterized by intra-articular bleeding, often requiring immobilization, which may result in muscle atrophy and impaired proprioception. Patients with haemophilia are at risk of haemarthrosis, soft-tissue haematomas, bruising, retroperitoneal bleeding, intra-cerebral haemorrhage, and post-surgical bleeding.

Knee, ankle and elbow joints are more commonly affected by haemophilic bleeding. People with haemophilia who have had many bleeds tend to develop a distinctive posture that may include: flexion deformities of the elbows, knees, and hips; an exaggerated arch in the back plantar-flexed ankles; pelvic asymmetry due to leg length differences; and varying amounts of muscle wasting. Physiotherapy is integral in the management of people with haemophilia. A key goal is to help maintain mobility, muscle strength, and balance. An individualized physiotherapy can raise the quality of life of a patient with haemophilia through increase of the physical function, pain reduction and prevention of bleeding.

The 80% of haemophilia patients have no access to pharmacological therapy and part of remaining 20% only receive treatment after a bleeding episode. In both cases, patients develop physical consequences before reaching adulthood require physiotherapy treatment to improve quality of life.