title: Physiotherapy home exercise program for haemophiliacs.
abstract: BACKGROUND
  Regular physiotherapy can improve the stability and flexibility of joints and decrease the bleeding risk in patients with haemophilia. To reduce the appointments for the patients and to make exercising a part of daily live, an individualized home exercise program (HEP) was designed. Retrospectively the number of bleedings during the HEP was compared to number of bleedings before.
  
  
  METHODS
  8 patients aged between 4 and 16 years with haemophilia A were evaluated. At start and after 13 month patients had a motion analysis via topographic ultrasound. According to the results and clinical findings an individualized HEP was created. Standardised scores for clinical evaluation and the patient based evaluation of exercises were designed. At every appointment exercises were individually adjusted.
  
  
  RESULTS
  Patients exercised in median 1.7 times a week. No training related bleeds occurred. 7 of 8 patients showed reduced joint and/or muscle bleeds (p<0.02). Clinical scores raised slightly in every patient. However the second motion analysis of squat and gait showed a worsening in 7 of 8 patients (p>0.05).
  
  
  CONCLUSIONS
  A HEP can help to advance in physical fitness and coordination and may reduce bleeding tendency, but needs to be accomplished regularly. Patients are interested but the motivation to exercise at home is low. Disorders measured by motion analysis seem not to be sufficiently influenced by our surrogate training program.
authors.affiliation: University Düesseldorf, Medical Faculty, Center of Child and Adolescent Medicine, Department of Pediatric Oncology, Hematology and Clinical Immunology, Düsseldorf, Germany. klaus.pierstorff @med.uni-duesseldorf.de
authors.forename: K
authors.initials: K
authors.lastname: Pierstorff
authors.forename: A
authors.initials: A
authors.lastname: Seuser
authors.forename: S
authors.initials: S
authors.lastname: Weinspach
authors.forename: H-J
authors.initials: HJ
authors.lastname: Laws
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006395:Hemarthrosis / Q000534:rehabilitation; D006467:Hemophilia A / Q000534:rehabilitation*; D006470:Hemorrhage / Q000517:prevention & control; D006801:Humans; D007719:Knee Joint; D008297:Male; D010349:Patient Compliance; D010809:Physical Fitness; D026741:Physical Therapy Modalities; D004856:Postural Balance; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012648:Self Care