The comprehensive care model of haemophilia is associated with better survival, less risk associated with accidents/surgery and more effective use of healthcare resources. Although there is, as yet, no literature to quantify the physiotherapy contribution to comprehensive care in haemophilia, the value of including a physiotherapist in the comprehensive care team lies in ready access to a unique knowledge of musculoskeletal anatomy, pathology and pathophysiology, biomechanics, exercise physiology and so on.
Physiotherapists undertake clinical assessment of joint health, strength, coordination, proprioception and musculoskeletal function. They are skilled at accurate diagnosis and long term monitoring of joint health. They can help to prevent bleeds and consequent joint damage by improving joint and muscle function, provide acute treatment for active bleeds, advise on appropriate sports participation and help patients to maintain a healthy body weight. And of course they can advise on pre- and post-surgical rehabilitation.
It is widely accepted that haemophilia comprehensive care centres should have available a dedicated physiotherapy service, while haemophilia treatment centres should have access to the services of a local physiotherapist with an awareness of haemophilia. Smaller centres should have physiotherapist support from a comprehensive care centre.
Haemophilia care in the UK has benefited from the activities of the Haemophilia Chartered Physiotherapists Association (HCPA). Over the past 10 years, the growth of the group has centred on an annual professional meeting that facilitated educational opportunities and professional networking, and has increasingly promoted research among members. The HCPA has now established a Clinical Studies Group, an open forum designed to identify and support research needs and to promote a collaborative approach to research that will answer some of the important questions that remain about haemophilia care.
Across Europe, the interests of haemophilia physiotherapists are promoted by the EAHAD Physiotherapy Committee, which is currently seeking to establish a network of physiotherapists across Europe working in haemophilia and other bleeding disorders.