The role of physiotherapy in haemophilia care

Comprehensive care for people with hemophilia (PWH) requires a coordinated multidisciplinary team approach inclusive of a physiotherapist. This article discusses key issues relevant to the physiotherapy management of PWH. Specificity of rehabilitation in children and adults with hemophilia Recent advances in treatment that involve regular prophylactic rather than episodic or on demand administration of coagulation factor concentrates have resulted in reduced bleeding frequency and improved quality of life meaning young boys with the condition now present with few clinical signs of joint damage. In contrast, adults who did not benefit from prophylaxis during childhood experienced recurrent joint hemarthroses triggering a degenerative process characterised by changes to articular cartilage and other joint structures. The rehabilitation of PWH therefore covers the spectrum from young boys with few clinical signs of joint damage to the older person with severe multiple joint arthropathy. The main aim of the physiotherapy management is to prevent episodes of bleeding and minimize the long-term deleterious musculoskeletal effects of hemophilia.