The Use of Primary Care Physiotherapy for Persons With Bleeding Disorders in the Netherlands-A Retrospective Study of Health Records.

Introduction: Patients with musculoskeletal complaints as a result of their bleeding disorder can benefit from primary care physiotherapy. The current study aims to describe physiotherapy services provided in primary care to patients with bleeding disorders and to what extent treatment was already in concordance with treatment recommendations as published in a clinical practice guideline in April 2024.

Methods: Researchers collected data from medical notes of primary care physiotherapists in the Netherlands treating a patient with a bleeding disorder. Collected data included; patient characteristics, condition for which treatment was initiated, total number of sessions, treatment modalities provided and outcome of treatment. Data from medical files was compared with 19 treatment recommendations stated in the newly developed clinical practice guideline.

Results: Data from 86 treatment episodes of 62 patients by 52 different physiotherapists was collected. Treatment episodes were initiated for haemophilic arthropathy (n = 47), joint bleed (n = 24), muscle bleed (n = 9) and synovitis (n = 6). The most frequently provided treatment modalities included manual techniques (in haemophilic arthropathy) and exercise therapy (in all other conditions). The percentage in which treatment was in concordance with the recommendation ranged between 17% and 100%.

Conclusion: The study indicated that exercise therapy was a commonly used treatment modality for all conditions. In contrast with other conditions, manual techniques were a frequently provided treatment modality in haemophilic arthropathy. Treatment was in many instances not in concordance with newly developed treatment recommendations. Dissemination and implementation of the recently developed treatment recommendations have the potential to improve primary care physiotherapy treatment for persons with bleeding disorders.