Intensive rehabilitation of a knee joint in hemophilic patients--a preliminary study.
One of the most typical symptoms of hemophilia are the intra-articular hemorrhages, which cause chronic synovitis, damage of the joint and eventually hemophilic arthropathy. Adequate treatment of chronic synovitis with antihemophilic globulin combined with appropriate physiotherapy and rehabilitation is of primary importance for suspending development of hemophilic arthropathy.


OBJECTIVE
The present study aims to explore the changes in the range of movements in the knee joint, mass and strength of thigh musculature as well as gait stability in hemophilic patients after conduction of intensive rehabilitation programme.


METHODS
Knee joints of 30 hemophilic patients were examined before and after conducting intensive rehabilitation. The assessments were done by angulometry of the knee joint, measurement of thigh circumference, and dynamometry. The rehabilitation course lasted 15 days. Kinesitherapy and modified physical factors were used in the treatment programme. Kinesitherapy included analytical exercises for the affected muscles and underwater gymnastics. The modified physical factors included electrotherapy with low-frequency impulse-magnetic field and interference currents.


RESULTS
The applied intensive rehabilitation programme lead to variously expressed improvement of the examined parameters.


CONCLUSIONS
The study results show that in most patients improvement of various degree is achieved which depends on the severity of damage of the locomotory apparatus. Prophylaxis with antihemophilic globulin combined with individually designed early rehabilitation is of crucial importance for maintenance of the musculoskeletal function in hemophilic patients.
Djourdjev
Boris A
BA
Department of Physiotherapy, Medical University, 15A Vassil Aprilov St., 4000 Plovdiv, Bulgaria.
Pavlova
Anna K
AK
D000293:Adolescent; D000328:Adult; D002648:Child; D006467:Hemophilia A / Q000150:complications*; D006801:Humans; D007592:Joint Diseases / Q000209:etiology* / Q000503:physiopathology / Q000534:rehabilitation*; D007719:Knee Joint / Q000503:physiopathology; D008297:Male