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HEMOPHILIA AND SPORT : FOR A SAFE PRACTICE
2019/03/23 Mihret Karahasanovic, MSc. pht CIUSSS de l’Estrie - CHUS ext
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Presentation plan Injuries in hemophilia Treatment of injuries Safety in sport
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1. MAJOR INJURIES
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When in doubt, treat and infuse
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Major injuries Head Neck / nose / mouth
If major : Headache Blurred vision Altered balance Nausea or vomiting Weakness Stiffness If minor : One dose Observe if major Neck / nose / mouth if : Neck swelling Neck or throat pain Difficulty swallowing Difficulty breathing Chest / gastrointestinal / urinary / génital if : Nausea or vomiting Blood in the urine Difficulty breathing Causes des blessures : trauma vs spontané
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NON-MAJOR MUSCULOSKELETAL INJURIES
2. NON-MAJOR MUSCULOSKELETAL INJURIES
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Joint bleed - Hemarthrosis
Main signs Loss in range of motiong Functional difficulties Pain Swelling Redness Heat
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Joint bleed - Hemarthrosis
Main synovial joints affected Elbow Knee Ankle
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Muscle bleed Main signs Swelling Bruising Redness Heat Stiffness Pain
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Muscle bleed Mainly in the large muscle groups Special attention to :
Iliopsoas muscle Compression of the femoral nerve Forearm and calf Compartment syndrome Signs of nerve compression : numbness, tingling, loss of sensitivity, muscle weakness Iliopsoas muscle Femoral nerve
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Treatment of non-major musculoskeletal injuries
3. Treatment of non-major musculoskeletal injuries
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Treatment of non-major musculoskeletal injuries
Prophylactic and supplemental factor intake according to the medical prescription Rest of the injured area Upper limb : rest Lower limb : avoid weight bearing Compression: light elastic bandage Elevation Progressive exercises with a physiotherapist Ice? No with a bleed
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Hemophilia Injury Recognition Tool
HIRT? Application developed by JoAnn Nilson, physiotherapist at the Saskatoon Hemophilia Treatment Center Hemophilia Injury Recognition Tool
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4. SAFE SPORT PRACTICE
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Prevention
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Le choix de l’activité Low impacts High impact Low supervision
Cycling Yoga Swimming Soccer Hockey Baseball Ex.: Ex.: Low supervision High supervision
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General advice Every hemophiliac is different
Avoid high-impact activities as much as possible Adequate protective equipment Initial supervision of the physiotherapist is recommended, for all ages Prophylaxis before the activity Accessibility of the additional factor Have fun!
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Conslusion Bénéfits > Risks Optimal activity Fun Security
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