Adult Bleeding Disorders Clinic, Health Sciences Centre, Winnipeg, Canada.
Haemophilia. 2010 Jul;16 Suppl 5:136-45. doi: 10.1111/j.1365-2516.2010.02312.x.
Exercise programmes for people with haemophilia are usually designed and implemented to help manage the recovery after a haemarthrosis or a muscle bleed, or as a tool to help prevent bleeding episodes from occurring. In this article, we have identified individual components of exercise that are often applied as separate entities, but may also need to be implemented in concert for optimized impact. Although it may be necessary on occasion to bias an exercise programme towards one component over the others, it is important to recognize that the various elements of exercise are not mutually exclusive. Decreased flexibility, strength and proprioception, will result in an impairment of balance and a loss of function. Programme design should whenever possible be guided by proven methodology in terms of how each component is incorporated, and more specifically how long to perform the exercise for and how many repetitions should be performed. We recognize, however, that this is not always possible and that there is significant value in drawing from the experience of clinicians with specialized training in the management of haemophilia. In this study, both perspectives are presented, providing reference-based reviews of the mechanics of the various elements of exercise as well as the expert opinions of the authors. Research that has been completed using patients with conditions other than haemophilia may or may not have a direct application with the bleeding disorders population, but the programme design based on principles of tissue healing in addition to disease specific knowledge should be encouraged.
针对血友病患者的运动方案通常旨在帮助管理关节积血或肌肉出血后的恢复，或者作为预防出血事件发生的工具。在本文中，我们确定了运动的各个组成部分，这些组成部分通常作为独立实体应用，但也可能需要协同实施以产生最佳效果。虽然有时可能需要使运动方案偏向于一个组成部分而不是其他组成部分，但重要的是要认识到运动的各个元素并不是相互排斥的。柔韧性、力量和本体感觉下降，会导致平衡受损和功能丧失。在设计方案时，应尽可能根据已证明的方法来指导每个组成部分的纳入，更具体地说，应指导运动的持续时间和应进行的重复次数。然而，我们认识到，这并不总是可行的，并且从具有血友病管理专业培训的临床医生的经验中汲取经验具有重要价值。在这项研究中，同时呈现了这两种观点，提供了关于运动各个组成部分的力学以及作者的专家意见的参考综述。使用除血友病以外的疾病患者完成的研究可能与出血性疾病患者直接相关，也可能不相关，但应鼓励基于组织愈合原则以及针对特定疾病的知识来进行方案设计。
