Isometric exercise for an individual with hemophilic arthropathy.

Several authors have described nonsurgical rehabilitative techniques for individuals with hemophilia who have single or recurrent hemarthroses. The effects of these low intensity exercise programs are not stated clearly in the literature. In this single-case experimental study, we investigated the effects of a training program of isometric exercise of at least two thirds of maximum voluntary contraction on the knee joint and surrounding muscles of a patient with hemophilia. A 12-year-old subject with severe factor-VIII deficiency and chronic knee arthroses was seen for baseline measurements, three weeks of treatment, and follow-up baseline measurements. The isometric exercise program safely increased right hamstring and quadriceps femoris muscle group strength 40% to 70% without adversely affecting knee range of motion, circumference, or skin temperature and without causing bleeding or discomfort. The use of isometric exercise programs during rehabilitation and maintenance is a promising treatment component for the total care of the individual with hemophilia.