South African Haemophilia Foundation (SAHF) Medical and Scientific Advisory Council (MASAC) Treatment Guidelines - Treatment of Bleeding Episodes

Bleeds in the Upper Limbs (Arms)

This guide is intended for people with haemophilia and healthcare personnel who may not be familiar with particular physiotherapy protocols pertaining to haemophilia management. A pdf version can be downloaded here.

If you are uncertain about anything, please contact Mrs Ethelwyn Remmers on +27 72 247 7352 or your nearest Haemophilia Treatment Centre to be referred to a Haemophilia Physiotherapist.

Bending and straightening (flexing and extending) as well as rotating movements (pronation and supination) are to be maintained or improved. Another aspect closely connected to exercising, is the development of good veins in order to facilitate infusion procedure. This can be achieved by squeezing a soft ball or similar object.

SHOULDER EXERCISES

Free elevation of the arm
Elevation against gravity
Shoulder and elbow extension with resistance (ball or weights)
Shoulder and elbow extension with resistance rubber band / tubing
Wrists, elbow and shoulder with body weight as resistance

ELBOW EXERCISES

Free elbow flexion against gravity
Free elbow extension against gravity
Elbow flexion with resistance (weights)
Elbow extension with resistance (weights)

WRIST EXERCISES

Free supination (turning palm up) and pronation (turning palm down)
Pronation and supination using a ruler or a stick as leverage
Stretching of muscle that bend the wrist and fingers