The effects of new methods of physiotherapy in patients with haemophilic arthropathy

Abstract

Advanced arthropathy mainly of the knee, hip or ankle joint occurs even in young adults with haemophilia. It has been proved that physical training increases isometric muscular strength and proprioceptive performance in haemophilia patients. The aim of this study was to present the new methods of physiotherapy process and their effect in patients with haemophilic arthropathy. Five subjects, aged from 32 to 42 years, with severe haemophilia A or B attended physiotherapy in a outpatient ambulatory setting over a 3-month period. The following treatment modalities were performed: walking on AlterG anti-gravity treadmill, deep penetrating electromagnetic stimulation (Salus Talent), manual physical therapy, mobilization and manipulation techniques, active muscle-strengthening exercises, post isometric relaxation (PIR) muscle energy techniques, as well as exercises for improvement of coordination, postural equilibrium and proprioception exercises using sensorimotor discs. The HJHS (Haemophilia Joint Health Score) has been used to assess the effectiveness of the treatment, VAS scale (Visual Analog Scale) to assess level of pain, TUG test (Timed Up and Go) to assess mobility as well as dynamic and static balance. Strength of the muscles acting on the joints improved, swelling of joints diminished and the level of pain decreased. An improvement of the dynamic and static balance was found as well. The range of motion did not change. Physiotherapy process did not provoke bleeding episodes in patients with haemophilic arthropathy included to the study.