Title : Advances in hemophilia rehabilitation
Abstract:
Physical medicine and rehabilitation aim to evaluate, diagnose, prevent and treat disability in people. Specifically in patients with hemophilia, its objective is to maintain the highest degree of functional capacity and independence, maintain neuromusculoskeletal functioning as much as possible, as well as prevent hemarthrosis and arthropathies.
The clinical evaluation in hemophilia is carried out based on the joint health scale (HJHS v. 2.1), which assesses joint characteristics such as inflammation, range of motion, crepitation, pain, muscle strength and gait. It is important to consider joint evaluation with ultrasound and other imaging studies such as magnetic resonance imaging.
Prevention of arthropathy is one of the main goals of treatment. Replacement with coagulation factor concentrates has been shown to prevent or reduce the impact of arthropathies
Rehabilitation treatment helps reduce pain, reduce hemarthroses, improve joint and muscle function, with the aim of reducing the impact of anatomical and/or physiological deficiencies, improving daily activities and thus the social and work participation of patients in their environment.
Rehabilitation treatment must consider pharmacological options, physiotherapy, occupational therapy, as well as the prescription of orthoses and/or prostheses, gait aids, technical aids, without neglecting the psychosocial aspects of the patients to have a comprehensive rehabilitation treatment that goes beyond physical therapy, hence the benefit of including a multidisciplinary team.
As in other pathologies, in hemophilia it has been demonstrated with evidence that the basis of rehabilitation treatment is therapeutic exercise (strengthening, balance, flexibility, proprioception), helping to reduce pain, increasing ranges of movement, strength, stability, improving the progress and quality of life of patients. Last but not least, another objective in rehabilitation is to encourage physical activity and sport in patients.
