Blood Disorder

Question 1

Classification of severity

Answer 1

o Mild:
- spontaneous bleeds are rare
- deep muscle and joint bleeds are uncommon
- injury/trauma/surgery trigger bleeding

o Moderate:
- spontaneous bleeds are rare;
- minor trauma can trigger major bleeding

o Severe:
- spontaneous bleeds can occur;
- slight trauma can cause bleeding into deep muscles and joints

Question 2

Muscle affected by hematomas

Answer 2

UL:
Forearm flexor

LL:
- Iliopsoas
- Gastroc

Question 3

Bleeding into joint space

Answer 3

Hemarthrosis: S/S
- Swelling, Warmth around joint
- Severe pain & Tenderness
- Joint stiffness
- Tingling sensation

**Common in synovial joints–>hip, knees, ankles, elbows

• Bleeding slows after several days when the joint is full of blood
• Long term complication:
  Chronic synovitis
  Chronic arthropathy–>bone and cartilage destruction

Question 4

PT Rx

Answer 4

Acute stage (active bleeding):
- PRICE
- Immobilization/ splinting–>prevent deformity
- Gait aid to prevent WB
- Joint protection

No ROM exercise

Subacute stage (after hemostasis):
- AAROM/AOM (pain free)
no PROM–>hard to tell tolerable range
- Isometric–>pain free OKC
CKC–>compressive force on affected joint
- Aquatic
- Pain Mx

Chronic Stage:
- Home Ex for joint ROM, strength & CP fitness
- CKC as tolerated
- Proprioception
Avoid contact sports, maximal lifts

Question 5

Anemia- RBC level

Answer 5

Normal Hb levels: males (14-18 g/dl) / females (12-16 g/dl).

Exercise needs to be decreased if Hb levels fall below 8g/dl.

Question 6

Muscle Hemorrhage S/S

Answer 6

• Bruising
• Gradual increase in pain
• Decreased movement of surrounding joints
• Protective muscle spasms
• Muscles assume a position of comfort (usually shortened)