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Rehabilitation of Muscle Dysfunction in Hemophilia

Musculoskeletal dysfunction is a common manifestation of haemophilia, and may be associated with imbalances between muscle groups. Evidence emerging from the literature suggests that the rehabilitation of this dysfunction is very relevant for the patient with musculoskeletal problems. Treatment of muscle imbalances may be linked with a reduction in recurrence of symptoms. Further research is needed to establish the relevance of this area in patients with haemophilia but the clinical experience supports the developing work in this field.

Haemarthroses and haematomas are common manifestations of haemophilia particularly in the severely affected patient where bleeding can occur spontaneously or follow minimal stresses. Bleeding into the muscles is said to account for between 10% to 30% of all musculoskeletal bleeding episodes (1, 2).

This paper will focus primarily on two areas. Firstly the initial physiotherapy management following common acute musculoskeletal haematomas will be outlined. The second section of the paper will focus on the assessment and principles of treatment for the correction of muscle imbalances which may follow either muscle bleeds or other muscle or joint problems which may occur in haemophilia. The rehabilitation process will be illustrated by two case studies.

Rehabilitation of Muscle Dysfunction in Hemophilia