Background Aging patients with severe hemophilia, often on-demand factor substitution, frequently
develop arthropathies in multiple joints, leading to significant limitations in physical
function, daily activities, and gait. Joint dysfunction, especially in the elbow,
threatens independence and quality of life (QoL), impacting decisions on suitable
living arrangements. This case presents a patient older than 65 years with acute right
elbow pain (VAS 6/10) and limited mobility (flexion-extension 90–40–0) due to advanced
hemophilic arthropathy, emphasizing the role of physical therapy in elbow rehabilitation.
At therapy initiation, the patient could no longer independently perform basic tasks
like administering clotting factor, shaving, or walking more than 100 meters, threatening
his ability to self-care and manage medical needs independently.
Method Physical therapy rehabilitation was provided through weekly 30-minute sessions over
9 weeks, utilizing techniques such as metabolism activation, mobilization techniques,
soft tissue treatments, and a function-based exercise program focused on the elbow.
During this phase, the patient's needs and concerns related to independent living
and specialized care requirements were also addressed.
Results Following the rehabilitation program, the patient’s elbow mobility improved to 120°–30°–0°
(flexion-extension-neutral position). Walking distance increased to 2000 meters, the
VAS pain score decreased to 2/10, and the SF-36 score reflecting overall quality of
life improved. The patient also noted that age-appropriate housing requires trained
staff for injections, fall prevention, hemophilia-specific assistance, and communication
with the hemophilia center.
Discussion Maintaining joint function through physical therapy, including mobilization and anti-inflammatory
treatments, is essential for improving the quality of life in aging patients with
hemophilia. In older age, QoL is closely linked to physical function, mobility, and
independence, as well as suitable living arrangements. As life expectancy for individuals
with hemophilia increases, their disease-related limitations require specific considerations
for age-appropriate housing and support structures to ensure optimal care.
Conclusion A reduction in joint function can significantly impair independence and mobility
in older individuals, particularly those with hemophilia. Age-appropriate housing
must account for hemophilia-specific needs, ensuring that patients receive the necessary
support to maintain their independence and quality of life.
