European principles of care for physiotherapy provision for persons with inherited bleeding disorders: Perspectives of physiotherapists and patients

Abstract

Introduction:In their Chronic Care Model, the World Health Organisation states that people with chronic disorders and their families should be informed about the expected course, potential complications, and effective strategies to prevent complications and manage symptoms. Physiotherapists are a key professional group involved in the triage, assessment and management of musculoskeletal conditions of persons with a bleeding disorder (PWBD). Nevertheless, recent reports describe access to physiotherapy for those with these conditions is only sometimes available.Aim: Access to high quality individualised physiotherapy should be ensured for all PWBD, including those with mild and moderate severities, male and female, people with von Willebrand Disease (vWD) and other rare bleeding disorders. Physiotherapy should be viewed as a basic requisite in their multidisciplinary care.Methods/ results: Following a series of meetings with physiotherapists representing the European Association for Haemophilia and Allied Disorders (EAHAD) and PWBD representing the European Haemophilia Consortium (EHC) and a review of This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

The evolution of physiotherapy in the multidisciplinary management of persons with haemophilia (PWH): A scoping review

“…Recently the “European Haemophilia Consortium and EAHAD Physiotherapy Committee 86 ” published eight principles that outline the standards that the physiotherapists dealing with haemophilia should follow. These professionals will need to collaborate with other specialists in the management of PWH, who in turn must have easy and consistent access to rehabilitation treatments.…”

Focus on musculoskeletal health in women with bleeding disorders

“…Regular physiotherapy is useful to develop, maintain and restore maximum movement and function and optimise quality of life. Recent guidelines recommend that physiotherapy should be available to everyone with a bleeding disorders, via self-referral [15] . As it can be difficult to find a physiotherapist who is experienced in treating people with bleeding disorders, the guidelines recommend that physiotherapists should work in partnership with other healthcare professionals to manage and provide services for people with bleeding disorders [15] .…”

Arthroscopic ankle surgery in people with haemophilia

“…[10][11][12][13] When ankle pain becomes unbearable despite conservative treatment, clinicians must resort to surgical solutions, several of which may be performed arthroscopically, including synovectomy, debridement and arthrodesis of the ankle. [10][11][12][13][14][15][16][17][18][19][20][21] The purpose of this article is to analyse the outcomes and complications of arthroscopic ankle surgery performed on PWH.…”

“…The first approach to the management of haemophilic ankle arthropathy should be conservative, with haematologic prophylaxis, analgesics, anti‐inflammatory drugs (COXIBS), physical medicine and rehabilitation (including orthothics, physiotherapy) 10–13 and intra‐articular injections of hyaluronic acid 10–13 . When ankle pain becomes unbearable despite conservative treatment, clinicians must resort to surgical solutions, several of which may be performed arthroscopically, including synovectomy, debridement and arthrodesis of the ankle 10–21 …”