Physiotherapy Rehabilitation and Housing Needs in Ageing Patients with Severe Hemophilia – A Case Report

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.

Publication History

Article published online:
23 October 2025