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Hamostaseologie 2018; 38(03): 141-149
DOI: 10.5482/HAMO-16-11-0044
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Physiotherapy Treatments in Musculoskeletal Pathologies Associated with Haemophilia

A literature review
Jesús Guodemar-Pérez
1   Universidad Camilo Jose Cela, Physiotherapy, Villafranca del Castillo, Madrid, Spain
,
Montserrat Ruiz-López
2   Universidad Camilo Jose Cela, Nursing, Villafranca del Castillo, Madrid, Spain
,
Elena Rodríguez-López
1   Universidad Camilo Jose Cela, Physiotherapy, Villafranca del Castillo, Madrid, Spain
,
Pablo García-Fernández
3   Universidad Alfonso X El Sabio, Physiotherapy, Villanueva de la Canada, Madrid, Spain
,
Juan Pablo Hervás-Pérez
1   Universidad Camilo Jose Cela, Physiotherapy, Villafranca del Castillo, Madrid, Spain
› Author Affiliations
Further Information

Publication History

28 November 2016

27 February 2017

Publication Date:
27 September 2018 (online)

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Summary

The aim of this study is to offer physiotherapists a synthesis of the main therapeutic tools available for the treatment of musculoskeletal pathologies in patients with haemophilia, according to the scientific literature. Although bleeds are recognised as no longer being a cause of death for people with haemophilia, the accompanying musculoskeletal injuries now represent the main problem associated with this disorder. There is a lack of clear guidelines to date regarding the physiotherapy treatment of these disorders. We performed a keyword searches of Pubmed, Scopus, Sciencedirect, Cochrane and PEDro databases. In total, 555 references were retrieved, of which only 55 fulfilled the inclusion criteria. Publications were grouped by the main symptoms caused by haemophilia and the physiotherapy treatments available. The literature reviewed shows that physiotherapists have a range of therapeutic tools at their disposal for the treatment of the main musculoskeletal disorders suffered by patients with haemophilia. Physiotherapy interventions act upon inflammation and pain, as well as favouring the reabsorption of haematomas, preventing muscle fibrosis and joint ankylosis and recovering the joint range from prior to the lesions. Also, these interventions help prevent muscle atrophy and provide patients with the optimal physical conditions for facing the small and repetitive injuries that, over time, can have a detrimental effect on their quality of life. Conclusion: Haemophilic patients suffer from a series of musculoskeletal disorders, which are associated with important functional disability. Physiotherapy and adapted sports are essential for decreasing disability and improving the quality of life of affected patients.

Zusammenfassung

Diese Studie stellt die laut wissenschaftlicher Literatur wichtigsten therapeutischen Methoden für die Behandlung muskuloskelettaler Schmerzen bei Hämophilie für Physiotherapeuten zusammen. Die mit Blutungen einhergehenden muskuloskelettalen Verletzungen sind ein großes Problem bei Hämophilie. Bislang mangelt es an klaren Richtlinien zur physiotherapeutischen Behandlung. Wir führten eine Schlüsselwortsuche in den Datenbanken PubMed, Scopus, ScienceDirect, Cochrane und PEDro durch. Diese ergab insgesamt 555 Literaturstellen, von denen nur 55 die Einschlusskriterien erfüllten. Die Publikationen wurden nach Hämophilie-bedingten Hauptsymptomen und verfügbaren Physiotherapien klassifiziert. Aus dem Literaturreview wurde ersichtlich, dass Physiotherapeuten über eine Reihe von Behandlungsmethoden für die wichtigsten muskuloskelettalen Störungen verfügen, unter denen Hämophilie-Patienten leiden. Physiotherapeutische Interventionen wirken gegen Entzündung und Schmerz, begünstigen die Resorption von Hämatomen, beugen einer Muskelfibrose und Versteifung von Gelenken vor und stellen die prämorbide Gelenkbeweglichkeit wieder her. Außerdem wirken sie prophylaktisch gegen eine Muskelatrophie und versetzen die Patienten in den optimalen körperlichen Zustand, um den kleinen und rezidivierenden Verletzungen zu begegnen, die mit der Zeit einen verheerenden Effekt auf die Lebensqualität haben können. Schlussfolgerung: Hämophilie-Patienten leiden unter verschiedenen muskuloskelettalen Störungen, die mit erheblichen funktionalen Behinderungen einhergehen. Physiotherapie und adaptierte Sportarten sind unerlässlich, um Behinderungen abzubauen und die Lebensqualität der betroffenen Patienten zu verbessern.

Keywords

haemophilic arthropathy - haematoma - synovitis - haemophilia - physiotherapy

Schlüsselwörter

hämophile Arthropathie - Hämaton - Synovitis - Hämophilie - Physiotherapie
 

  • References

  • 1 Bowen DJ. Haemophilia A and haemophilia B: molecular insights. Mol Pathol 2002; 55 (02) 127-144
    CrossrefPubMedGoogle Scholar
  • 2 CDC. Hemophilia. https://www.cdc.gov/ncbddd/hemophilia/data.html (March 3, 2017)
    PubMedGoogle Scholar
  • 3 Altisent Roca C. Características generales y clínicas de la hemofilia. In: Querol Fuentes F dir. Guía de rehabilitación en hemofilia. Barcelona: Ediciones Mayo; 2001: 3-4
    Google Scholar
  • 4 Querol Fuentes F, Aznar Lucea JA. Aspectos históricos de la ortopedia y la rehabilitación en hemofilia. In: Querol Fuentes F dir. Guía de rehabilitación en hemofilia. Barcelona: Ediciones Mayo; 2001: 5-7
    Google Scholar
  • 5 Fundacion de la hemofilia. http://www.fhemofilia.org.ar (March 3, 2017)
    PubMed
  • 6 Ordi Ros J, Altisent Roca C. Hemofilia adquirida. Med Clin (Barc) 2002; 119 (20) 773-775
    CrossrefPubMedGoogle Scholar
  • 7 Almendáriz Juárez A, Altisent Roca C. Artropatía hemofílica. In: Querol Fuentes F dir. Guía de rehabilitación en hemofilia. Barcelona: Ediciones Mayo; 2001: 57-62
    Google Scholar
  • 8 Querol F, Haya S, Aznar JA. Lesiones musculoesqueléticas en hemofilia. Rev Iberoamer Tromb Hemostas 2001; 14 (02) 111-117
    PubMedGoogle Scholar
  • 9 Viso Sarmiento M, López Fernández MF. et al. Coagulopatía. Criterios diagnósticos y tratamiento. Medicine 2001; 08: 2809-2816
    PubMedGoogle Scholar
  • 10 Tusell J. Profilaxis primaria en hemofilia. Rev Iberoamer Tromb Hemostasia 2001; 14: 119-122
    PubMedGoogle Scholar
  • 11 Lobet S, Hermans C, Lambert C. Optimal management of hemophilic arthropathy and hematomas. J Blood Med 2014; 5: 207-218
    PubMedGoogle Scholar
  • 12 Querol F, Rodriguez-Merchan EC. The role of ultrasonography in the diagnosis of the musculo-skeletal problems of haemophilia. Haemophilia 2012; 18 (03) e215-e226
    CrossrefPubMedGoogle Scholar
  • 13 Khan U, Bogue C, Ungar WJ. et al. Cost-effectiveness analysis of different imaging strategies for diagnosis of haemophilic arthropathy. Haemophilia 2010; 16 (02) 322-332
    CrossrefPubMedGoogle Scholar
  • 14 Fernández Palazzi F, Caviglia H, Bernal R. Problemas ortopédicos del niño hemofílico. Revista de Ortopedia y Traumatología 2001; 45: 144-150
    PubMedGoogle Scholar
  • 15 Seuser A, Böhm P, Wermes C. Early orthopaedic challenges in haemophilia patients and therapeutic approach. Thromb Res 2014; 134 (Suppl. 01) S61-S67
    CrossrefPubMedGoogle Scholar
  • 16 Bladen M, Alderson L, Khair K. et al. Can early subclinical gait changes in children with haemophilia be identified using the GAITRite walkway. Haemophilia 2007; 13 (05) 542-547
    CrossrefPubMedGoogle Scholar
  • 17 Utukuri MM, Goddard NJ. Haemophilic arthropathy of the elbow. Review. Haemophilia 2005; 11 (06) 565-570
    CrossrefPubMedGoogle Scholar
  • 18 Dalzell R. Shoulder hemiarthroplasty to manage haemophilic arthropathy: two case studies. Haemophilia 2004; 10 (05) 649-654
    CrossrefPubMedGoogle Scholar
  • 19 Solimeno L, Luck J, Fondanesche C. et al. Knee arthropathy: when things go wrong. Review. Haemophilia 2012; 18 (Suppl. 04) 105-111
    CrossrefPubMedGoogle Scholar
  • 20 Rodríguez Merchán EC. Problemas ortopédicos del paciente hemofílico adulto. Revista de Ortopedia y Traumatología 2001; 45: 151-159
    PubMedGoogle Scholar
  • 21 Aznar JA, Querol F. Lesiones musculoesqueléticas en hemofilia: hemartrosis. Rev Iberoamer Tromb Hemostasia 2001; 14: 50-57
    PubMedGoogle Scholar
  • 22 Hermans C, De Moerloose P, Fischer K. et al. Management of acute haemarthrosis in haemophilia A without inhibitors: literature review, European survey and recommendations. European Haemophilia Therapy Standardisation Board. Haemophilia 2011; 17 (03) 383-392
    CrossrefPubMedGoogle Scholar
  • 23 Bergés García A, Vélez María A. Estado actual y recomendaciones para la profilaxis de la hemofilia en México. Rev Hematol Mex 2012; 13 (12) 84-88
    PubMedGoogle Scholar
  • 24 Cuesta-Barriuso R, Gómez-Conesa A, López-Pina JA. Manual therapy in the treatment of ankle hemophilic arthropathy. A randomised pilot study. Physiother Theory Pract 2014; 30 (08) 534-539
    CrossrefPubMedGoogle Scholar
  • 25 Querol Fuentes F, Aznar Lucea JA. Técnicas fisioterápicas. In: Querol Fuentes F dir. Guía de rehabilitación en hemofilia. Barcelona: Ediciones Mayo; 2001: 19-27
    Google Scholar
  • 26 Buzzard BM. Physiotherapy, rehabilitation and sports in countries with limited replacement coagulation factor supply. Haemophilia 2007; 13 (Suppl. 02) 44-46
    CrossrefPubMedGoogle Scholar
  • 27 La incertidumbre del futuro desde el presente condicionado. Hemofilia 2001; 60 (1383): 9
    PubMedGoogle Scholar
  • 28 Querol Fuentes F, Aznar Lucea JA. Lesiones musculoesquéleticas en hemofilia: hemartrosis. In: Querol Fuentes F dir. Guía de rehabilitación en hemofilia. Barcelona: Ediciones Mayo; 2001: 31-41
    Google Scholar
  • 29 Pasta G, Forsyth A, Merchan CR. et al. Orthopaedic management of haemophilia arthropathy of the ankle. Haemophilia 2008; 14 (Suppl. 03) 170-176
    CrossrefPubMedGoogle Scholar
  • 30 Dalzell R. Shoulder hemiarthroplasty to manage haemophilic arthropathy: two case studies. Haemophilia 2004; 10 (05) 649-654
    CrossrefPubMedGoogle Scholar
  • 31 Young G, Tachdjian R, Baumann K, Panopoulos G. Comprehensive management of chronic pain in haemophilia. Haemophilia 2014; 20 (02) e113-e120
    CrossrefPubMedGoogle Scholar
  • 32 Santavirta N, Solovieva S, Helkama O. et al. Musculoskeletal pain and functional ability in haemophilia A and B. Physiotherapy and rehabilitation in haemophilia patients. Rheumatol Int 2001; 21 (01) 15-19
    CrossrefPubMedGoogle Scholar
  • 33 Kalnins W, Schelle G, Jost K. et al. Pain therapy in haemophilia in Germany. Patient survey (BESTH study). Hamostaseologie 2015; 35 (02) 167-173
    Article in Thieme ConnectPubMedGoogle Scholar
  • 34 Almendáriz Juárez A, Altisent Roca C. Hematomas musculares. In: Querol Fuentes F dir. Guía de rehabilitación en hemofilia. Barcelona: Ediciones Mayo; 2001: 51-55
    Google Scholar
  • 35 Querol F, Haya S, Aznar JA. Lesiones musculoesqueléticas en hemofilia: hematomas musculares. Rev Iberoamer Tromb Hemostasia 2001; 14 (02) 111-117
    PubMedGoogle Scholar
  • 36 Navarro Monsoliv R, Querol Fuentes F. Rehabilitación de los hematomas musculares en los pacientes hemofílicos. Rehabilitación 2015; 39 (02) 59-65
    PubMedGoogle Scholar
  • 37 Heijnen L, de Kleijn P. Physiotherapy for the treatment of articular contractures in haemophilia. Haemophilia 1999; 5 (Suppl. 01) 16-19
    CrossrefPubMedGoogle Scholar
  • 38 Sørensen B, Benson GM, Bladen M. et al. Management of muscle haematomas in patients with severe haemophilia in an evidence-poor world. Haemophilia 2012; 18 (04) 598-606
    CrossrefPubMedGoogle Scholar
  • 39 Alcalay M. Muscular complications of hemophilia. Arch Pediatr 2009; 16 (02) 196-200
    CrossrefPubMedGoogle Scholar
  • 40 López Cabarcos C. Valoración clínica del aparato locomotor. In: Querol Fuentes F dir. Guía de rehabilitación en hemofilia. Barcelona: Ediciones Mayo; 2001: 9-18
    Google Scholar
  • 41 D‘Young AI. Conservative physiotherapeutic management of chronic haematomata and haemophilic pseudotumours: case study and comparison to historical management. Haemophilia 2009; 15 (01) 253-260
    CrossrefPubMedGoogle Scholar
  • 42 Ghosh K, Ghosh K. Management of chronic synovitis in patients with hemophilia: with special reference to developing countries. Indian J Hematol Blood Transfus 2008; 24 (04) 151-154
    CrossrefPubMedGoogle Scholar
  • 43 Querol Fuentes F, Aznar Lucea JA, Aparisi Rodríguez F. Sinovitis y sinovioartrosis. In: Querol Fuentes F dir. Guía de rehabilitación en hemofilia. Barcelona: Ediciones Mayo; 2001: 43-50
    Google Scholar
  • 44 Ravanbod R, Torkaman G, Esteki A. Comparison between pulsed ultrasound and low level laser therapy on experimental haemarthrosis. Haemophilia 2013; 19 (03) 420-425
    CrossrefPubMedGoogle Scholar
  • 45 Cuesta-Barriuso R, Gómez-Conesa A, López-Pina JA. Physiotherapy treatment in patients with hemophilia and chronic ankle arthropathy: a systematic review. Rehabil Res Pract 2013; 2013: 305249
    PubMedGoogle Scholar
  • 46 Cuesta-Barriuso R, Torres-Ortuño A, López-García M, Nieto-Munuera J. Effectiveness of an educational intervention of physiotherapy in parents of children with haemophilia. Haemophilia 2014; 20 (06) 866-872
    CrossrefPubMedGoogle Scholar
  • 47 Goto M, Takedani H, Haga N. et al. Self-monitoring has potential for home exercise programmes in patients with haemophilia. Haemophilia 2014; 20 (02) e121-e127
    CrossrefPubMedGoogle Scholar
  • 48 Negrier C, Seuser A, Forsyth A. et al. The benefits of exercise for patients with haemophilia and recommendations for safe and effective physical activity. Review. Haemophilia 2013; 19 (04) 487-498
    CrossrefPubMedGoogle Scholar
  • 49 Stephensen D, Rodriguez-Merchan EC. Orthopaedic co-morbidities in the elderly haemophilia population: a review. Review. Haemophilia 2013; 19 (02) 166-173
    CrossrefPubMedGoogle Scholar
  • 50 Blamey G, Forsyth A, Zourikian N. et al. Comprehensive elements of a physiotherapy exercise programme in haemophilia–a global perspective. Review. Haemophilia 2010; 16 (Suppl. 05) 136-145
    PubMedGoogle Scholar
  • 51 Von Mackensen S, Eifrig B, Zäch D. et al. The impact of a specific aqua-training for adult haemophilic patients–results of the WATERCISE study (WAT-QoL). Haemophilia 2012; 18 (05) 714-721
    CrossrefPubMedGoogle Scholar
  • 52 Stemberger M, Schmit E, Czepa D. et al. Climbing therapy under PK-tailored prophylaxis. Hamostaseologie 2014; 34 (Suppl. 01) S13-S16
    Article in Thieme ConnectPubMedGoogle Scholar
  • 53 Petrini P, Seuser A. Haemophilia care in adolescents–compliance and lifestyle issues. Review. Haemophilia 2009; 15 (Suppl. 01) 15-19
    CrossrefPubMedGoogle Scholar
  • 54 Heijnen L. The role of rehabilitation and sports in haemophilia patients with inhibitors. Haemophilia 2008; 14 (Suppl. 06) 45-51
    CrossrefPubMedGoogle Scholar
  • 55 Gomis M, Querol F, Gallach JE. et al. Exercise and sport in the treatment of haemophilic patients: a systematic review. Review. Haemophilia 2009; 15 (01) 43-54
    CrossrefPubMedGoogle Scholar
  • 56 Wittmeier K, Mulder K. Enhancing lifestyle for individuals with haemophilia through physical activity and exercise: the role of physiotherapy. Haemophilia 2007; 13 (Suppl. 02) 31-37
    CrossrefPubMedGoogle Scholar
  • 57 Souza JCl, Simoes HG, Campbell CS. et al. Haemophilia and exercise. Int J Sports Med 2012; 33 (02) 83-88
    Article in Thieme ConnectPubMedGoogle Scholar
  • 58 Pérez-Alenda S, Gallach JE, Devís-Devís J. et al. Hemofilia: ejercicio y deporte. Apunts Med Esport 2011; 46 (169) 29-39
    PubMedGoogle Scholar