Counselling guidelines for managing musculoskeletal problems in haemophilia in the 1990s

Miller, Riva; Beeton, Karen; Goldman, Eleanor; Ribbans, William J

doi:10.1046/j.1365-2516.1997.00058.x

Cited by 15 publications

(5 citation statements)

References 13 publications

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“…More often than not, the physical problems that these patients face make it difficult for them to perform everyday activities normally [12,13]. These problems are intensified in elderly haemophiliacs who also suffer arthritis and are at risk of falls with all the obvious consequences involved.…”

Section: Resultsmentioning

confidence: 99%

Exercise and sport in the treatment of haemophilic patients: a systematic review

et al. 2009

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In haemophiliacs, the physical condition, muscular strength, aerobic resistance, anaerobic resistance and proprioception have all diminished. Muscle atrophy and instability, being more vulnerable to stressful motor demands, increase the risk of lesion and establish a vicious circle that is hard to break: pain, immobility, atrophy, articular instability and repeated bleeding episodes. In haemophilia, physical and/or sporting activities were not recommended until the seventies. Nowadays, the overall policy is to recommend certain physical activities, especially swimming, to improve the patient's quality of life, thanks to prophylaxis programmes. The objective of this study is to perform a systematic review of the exercise and sporting activities recommended for haemophiliacs. Experimental and observational studies and clinical assays about rehabilitation for haemophiliacs with exercise and sporting activities have been included. The relevant studies were identified in Medline, Cinahl, Embase and SportDiscus, and key words were: haemophilia, exercise and sport (with no language restrictions). Works were independently analysed by reviewers and the following were identified: of 3603 studies, 103 were included in this review: 29 (28.15%) were experimental, 27 (26.21%) were observational and 47 (45.63%) were clinical. Physiotherapy, physical activity and sport are basic elements to improve quality of life and the physical condition, increase strength and resistance and to reduce the risk of musculoskeletal lesions and to prevent haemophilic atrophy. In general, professionals in haemophilia believe that regular exercise and rehabilitation with physiotherapy is fundamental, particularly in countries where replacement therapy is not readily available.

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Section: Resultsmentioning

confidence: 99%

Exercise and sport in the treatment of haemophilic patients: a systematic review

et al. 2009

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“…Further studies are required to evaluate the long-term outcome of total joint arthroplasty in these patients including; infection rates in HIVpositive patients; the provision of antibiotic prophylaxis; aseptic loosening of cemented compared to non-cemented THA, and cost±bene®t analyses in view of the considerable expenditure involved [19]. It is important for the patient to have realistic expectations of what surgery can offer [45] and the importance of an experienced multidisciplinary team in the management of the haemophilic patient is paramount. Despite improvements in medical treatment, arthropathy remains a problem for many patients.…”

Section: Resultsmentioning

confidence: 99%

Total joint arthroplasty in haemophilia

2000

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In severely affected haemophilic patients arthropathy is a common problem which can lead to considerable pain and functional deficit. Surgical management, including total joint arthroplasty, can be undertaken if conservative management fails. A search of the literature showed that a number of studies describing the use of total knee arthroplasty (TKA) and total hip arthroplasty (THA) in haemophilia have been published, whereas shoulder, elbow and ankle arthroplasties are confined to case reports. This paper reviews the functional outcome of arthroplasty in the different joints, the postoperative and long-term complications, and the impact of HIV. Although complications are commonly described and the surgery is technically demanding, the results suggest that arthroplasty, particularly of the hip and knee, can be a valuable option in the management of severe haemophilic arthropathy.

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“…Advice regarding suitable educational, sporting and later employment activities must be proffered. The ideal environment is during musculo‐skeletal review clinics when the advice of a multidisciplinary team should be available [15].…”

Section: Biomechanics Of Equinus Deformitiesmentioning

confidence: 99%

Management of equinus contractures of the ankle in haemophilia

Ribbans

Rees

1999

Haemophilia

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Equinus deformity has been a significant problem in haemophilia. It causes difficulties in walking and secondary problems in adjacent joints. There are a number of potential causes in haemophilia. A careful history, examination, and plain radiographs will determine the aetiology, which frequently is multifactorial. Hopefully, prophylactic factor replacement will reduce the incidence of such problems in the future. Prompt 'on demand' therapy will reduce the complications of articular and soft-tissue bleeds. Physiotherapy, splints, and orthotics will usually allow a full recovery of function and comfort. Rarely, surgical intervention is required to correct articular and/or musculo-tendinous problems. The choice of surgery depends upon the cause(s) of the deformity and should only be undertaken in experienced haemophilia units following careful counselling of the patient regarding the aims and nature of the operation and the patient's involvement in an effective rehabilitation programme.

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Counselling guidelines for managing musculoskeletal problems in haemophilia in the 1990s

Cited by 15 publications

References 13 publications

Exercise and sport in the treatment of haemophilic patients: a systematic review

Exercise and sport in the treatment of haemophilic patients: a systematic review

Total joint arthroplasty in haemophilia

Management of equinus contractures of the ankle in haemophilia

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