Impact of physiotherapy on the functional status of elbow and knee joints and quality of life in patients with hemophilia.

Background. The objective of our research was to assess the impact of physiotherapy on the frequency of intraarticular and intramuscular hemorrhages and on elbow and knee joint function, in hemophilic patients. Material and methods. We examined 22 boys, 6-14 years of age, suffering from hemophilia A. The research program included patient history in respect to intraarticular hemorrhages in elbows and knees before therapy, observation of intra-articular bleeding during physiotherapy, goniometric measurements of the range of movement in the elbow and knee, measurement of the circumference of the arm, forearm, thigh and calf, and momentum dynamometric measurements of the relative and absolute force of the flexors and extensors of the lower leg at the knee joints and of the forearm at the elbow joints, in static conditions. The treatment program included deficit coagulant agent replacement therapy, physiotherapy, and kinesitherapy. Results. The physiotherapy program we applied resulted in a considerable improvement in mobility, as well as increased muscle strength and mass. Conclusions. Our research showed that, due to the application of the appropriate replacement treatment, there was a decrease in the frequency and size of intraarticular hemorrhages, despite intense rehabilitation and physical activity.