Abstract

A Case Study on the Effect of Physiotherapy on Joint Health and Functional Independence in a Person with Hemophilia who Underwent Upper Limb Fasciotomy

Background and Purpose: Persons with acquired or congenital hemophilia are at risk of developing acute compartment syndrome, which can complicate rehabilitation therapy. However, there is a lack of published literature on the role of physiotherapy in post-fasciotomy hemophilia cases. The study aims to investigate the impact of physiotherapy on post-operative upper limb fasciotomy in improving joint health, functional ability, range of motion and decreasing pain in person with hemophilia. Case Description: The case involves a 22 years old male subject with hemophilia A, diagnosed in 2004 with a factor assay of 1.2%. The subject presented with a history of left forearm pain after an intramuscular hematoma in the left forearm, leading to compartment syndrome and mild Volkmann ischemic contracture. The subject also experienced difficulty in gripping with the left hand and pain. Hemophilia Joint Health Score (HJHS), Functional Independence Score in Hemophilia (FISH), and score of Numeric Pain Rating Scale and Range of Motion were used as outcome measures. The physiotherapeutic interventions were given for 40 minutes for 4 weeks with five therapy sessions per week. Results: The findings of this study demonstrated a significant improvement in the outcome parameters with a decrease in HJHS score (8.8%), increase in score of FISH (15.6%), decrease in NPRS score (40%) and improved range of motion of wrist joint. Conclusion: In conclusion, this case study suggests that basic physiotherapy interventions lead to increased range of motion, improved joint health and decreased pain in post-operative cases of fasciotomy presenting as intramuscular hematoma with compartment syndrome in persons with hemophilia. These improvements contribute to enhanced functional independence.

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