Times of India
02 July 2010
By Isha Jain
Lucknow, India

It had been 10 harsh years for Fakkruddin, during which he could not even stand, let alone walk on his own. An acquaintance suggested that Fakkruddin – a severe haemophiliac – visit a physiotherapist and since then he has not looked back. “Thanks to the exercises, I can now walk with the help of a stick...I had to suffer a lot of pain when I began with the exercises but now I feel happy and hope that soon I would be perfectly fine,”said Fakkruddin.

He is not alone. Two other haemophiliacs, Churchill Dwivedi, 12 years old and Om Gupta, 16 years old, have shown huge improvement when they tried physiotherapy. “Churchill has shown tremendous improvement. We brought him to the physiotherapist in November, 2009 and in the past eight months, we can say he has got 60 per cent better. Doctors say that in another two to three months, he would be able to walk on his own,”said A K Dwivedi, father of Churchill.

Haemophilia is a group of genetic hereditary disorders that impairs the body’s ability to control blood clotting or coagulation, which is used to stop bleeding when a blood vessel is ruptured. “It is mostly the joints that bleed in case of haemophilia. Apart from that, the bleeding can be in muscles, brain, gastrointestinal tract. Repeated bleeding of the same joint can lead to deformation of that particular joint which can lead to disability,”said Geeta Suri, physiotherapist.

Other than using Anti Haemophilic Factor (AHF), the only thing that can cure a haemophiliac is physiotherapy. “Simple warm up exercises coupled with strengthening exercises by using weights has helped kids in walking. But these exercises have to be done on a regular basis so as to achieve perfection,”said Geeta.

In the fist set of exercises, children are made to rotate their limbs at the joints, tying and opening of fists, up and down movement of the ankles, and deep breathing for a minimum of 5 to 10 minutes. “When we see a child easily carrying on with the simple exercises, he is made to do strengthening exercise by using weights depending upon the comfort level,”said Geeta.

The strengthening exercises make use of various kinds of machines to help a haemophiliac in walking. The first is traction that is used to maintain the space between the joints.

“For reducing pain that occurs in the joints due to deformation, transcutaneous electrical nerve stimulation (TENS) is used. Once the haemophiliac gets relief from the pain, the muscle strengthening process is carried out with the help of electrical muscle stimulation,”said Geeta. The last step, however, is mobilisation, which is a technique to maintain the range of joints, added Geeta.

The technique of mobilisation is called serial casting under general anaesthesia. The process includes giving partial anaesthesia to the haemophiliacs and then the joints where deformation has taken place are stretched to the maximum level.

The entire stretched part is then plastered. Besides the exercises, these patients have to take haemophilic factors but not on daily basis.