Effectiveness of a balance training home exercise programme for adults with haemophilia: a pilot study

Abstract

Adults with haemophilia and other bleeding disorders often develop lower limb musculoskeletal problems associated with bleeds into joints and muscles, which may affect balance performance and increase likelihood of falling. The aim of this study was to evaluate the effectiveness of an individualized balance and strength home exercise programme on improving balance and related outcomes for adults with haemophilia and other bleeding disorders. Twenty male adults with haemophilia and other bleeding disorders (mean age 39.4 years, 95% CI = 33.7-45.1) were recruited to participate. They underwent a comprehensive clinical and force platform assessment of balance and related measures. Based on assessment findings, the assessing physiotherapist provided an individualized home exercise programme of balance, strengthening and walking exercises. Re-assessment occurred after the 4-month exercise programme. Twelve participants (60%) completed the programme and were re-assessed. There were no safety problems or dropouts associated with the exercise programme aggravating joint status. Although there were no statistically significant changes in any of the measures (adjusted for multiple comparisons), there were improvements of between 5% and 22% on 10 of the 16 measures, with the Neurocom modified Clinical Test of Sensory Interaction on Balance (P = 0.036) and Timed Sit to Stand (P = 0.064) approaching significance. A tailored home exercise programme targeting balance, strengthening and walking is feasible for adults with haemophilia and other bleeding disorders. These results suggest that positive physical outcomes including improved balance and mobility may be achieved with this type of programme.

Manual therapy in the treatment of ankle hemophilic arthropathy. A randomized pilot study

“…This absence of bleeding during treatment and during the follow-up period contrasts with the events that had occurred during the previous year. Other studies indicate that during treatment with proprioception and strength training for four months (Hill et al, 2010) and six months (Hilberg et al, 2003), there was no haemarthrosis, but we cannot ensure that the rehabilitation will always be safe, since Gurcay et al (2008) reported haemarthrosis in two of 31 subjects, during four weeks of treatment focusing on strength and proprioception.…”

Balance, falls, and exercise: Beliefs and experiences in people with hemophilia: A qualitative study

“…Prior research has established that falls are commonplace in adults with hemophilia,1, 2 and advises that physical therapy and exercise are successful in fall prevention 3, 4. Limited exercise and physical activity leads to a decline in balance, increasing fall risk 5.…”

Effect of Using Treadmill Exercise on Mobility Skills in Hemophilic Children

“…All the children participated in the current study received 75 minutes of treatment session, three times per week for a period of three successive months .For Control group; the children of this group received special physical therapy program (ultrasonic therapy 10 min, electrotherapy 20 min, bicycle ergometer training 20 min and selected physical therapy exercises 25 min) which include; exercises to facilitate balance [12,13], stretching exercise for tightening muscles aiming to maintain length and elastic recoil of all soft tissue liable to be tight especially the achilles tendon, hamstring, hip flexors and adductors of lower limbs and wrists, fingers flexors and elbows flexors [14,15], strengthening exercises as static muscle contraction for quadriceps, hamstrings, dorsiflexors and planter flexors [16][17][18], ultrasonic therapy (pulsed ultrasound waves of 1 MHZ frequency and 1.5 W/ cm2) [19] and electrical stimulation (inform of faradic stimulation current, pulses of 0.1-1 ms with repetition rates of 30-100 Hz. with pulses repeated at 100 Hz the time period for each cycle is 10 ms, so with a 1 ms pulse the rest period is 9 ms these pulses may be unidirectional and are thus short duration or they may be biphasic) [20,21].…”