Physiotherapy for children with haemophilia

Physiotherapy is an important part of the treatment and management for children and young people with haemophilia.

What will my physiotherapist do?

Your physiotherapist is part of the haemophilia team and their role is to monitor your joints and make sure any changes in how much you can move your joints are noticed as early as possible. They may give you exercises to be completed at home if needed. When you see the physiotherapist they will complete a joint score called haemophilia joint health score (HJHS). You can also contact the physiotherapist between your clinic appointments if you are having any other aches and pains.

What is the haemophilia joint health score (HJHS)?

This is scoring system which helps identify any changes in your joints as early as possible. It should be completed twice a year for all children with:

• severe haemophilia A or B
• moderate haemophilia A or B if prophylaxis is taken

It is usually done at the same time as your normal clinic appointment. The assessment looks at:

• joint range of movement
• muscle strength
• balance
• walking
• running
• hopping

What do I need to wear?

Please try to have shorts and a short sleeved top for the assessment. You can bring these to get changed into once you arrive if needed.

How long will it take?

The assessment takes about 45 minutes to complete.

Why does the physiotherapist monitor my joints?

When you have a bleed into your joint it causes inflammation to the cartilage of the joint (this is the soft, cushioning over the end of the bones). If you have repeated bleeds in the same joint this inflammation can lead to joint damage.

These joint changes and damage can lead to pain and mobility or movement problems as you get older. It is really important that we monitor and look after your joints now to protect them for the rest of your life.

Are all aches and pains I get related to my haemophilia?

Many children and teenagers get joint and muscle aches and pains. There are several reasons you may develop these such as:

• injury
• change in exercise levels
• a growth spurt
• a result of a bleed related to your haemophilia

You are able to access physiotherapy for any joint or muscle problem, not just if you feel it is related to a joint or a muscle bleed.

It is important that you contact the haemophilia centre if you think you have had a joint or muscle bleed. If you need advice on any other aches or pains please contact the physiotherapist directly or via the haemophilia centre.