Author(s)

Angela Forsyth^1*, Greig Blamey², Sébastien Lobet³, Paul McLaughlin⁴

¹REBUILD Program, Diplomat Specialty Infusion Group, Cincinnati, OH, USA.
²Manitoba Inherited Bleeding Disorders Program, Health Sciences Center, Winnipeg, MB, Canada.
³Cliniques Universitaires Saint-Luc, Service d’Hématologie, Brussels, Belgium.
⁴Hemophilia Centre and Thrombosis Unit, Royal Free London, London, UK.

People with hemophilia (PWH) have impaired blood coagulation and hemostasis. Bleeding into joints and muscles is the main manifestation of the disorder, causing severe joint damage and muscle complications. Lifelong, regular physical therapy is therefore important for PWH, in order to support recovery from bleeds and reduce recurrences. Ideally, these individuals should be in the care of a hemophilia treatment center (HTC), where a physical therapist (PT) should be a regular part of the comprehensive team. However, not all PWH have convenient access to an HTC, and they may be referred to local non-specialist PTs, who may have only limited experience with the condition, for day-to-day physical therapy treatment. This article, written by four experienced hemophilia PTs, introduces key aspects of the pathology of the hemophilic joint in adult PWH with musculoskeletal complications or established joint disease (or those with inhibitors) that are relevant to PTs. The characteristic differences between the joints of PWH and those of people with similar pathologies are clarified. Practical advice on how the physical therapy consultation can be adjusted for PWH is given, and the importance of communicating with the HTC emphasized. The aim of this narrative review is to raise awareness of hemophilia and joint disease for non-specialist PTs, and serve as helpful background information for PTs who encounter PWH with musculoskeletal complications or established joint disease in their clinics.

Hemophilia, Joint Diseases, Physical Therapy

Forsyth, A. , Blamey, G. , Lobet, S. and McLaughlin, P. (2020) Practical Guidance for Non-Specialist Physical Therapists Managing People with Hemophilia and Musculoskeletal Complications. Health, 12, 158-179. doi: 10.4236/health.2020.122014.