Table 2.

Rehabilitation after TKA in patients with haemophilia

Inpatient rehabilitation	• Pain evaluation with visual analogue scale • Ice (3 times per day) with lower extremity elevated 20 to 30 minutes • Continuous passive motion (first week after surgery) • Weight-bearing as tolerated • Ambulation with walker • Observation of the incision • Increase the knee flexion gradually
Exercises Post-operative day 1	• Ankle pumping • Isometrics for quadriceps, gluteal and hip abductor muscles • Heel-slide exercises • Weight-bearing exercises • Transvers to chair or to bathroom from bed
Post-operative day 2	• Continue the previous exercises • Active assistive range of knee motion exercises • Active assistive (AA) straight leg raises (SLR) • Knee extension exercises
Post-operative days 3 to 5	• Continue the previous exercises • Increase the walking distance • Stair ascending and descending
Post-operative	Goals	Exercises
Weeks 1 to 4	• Progression of the early phase exercises • Full knee extension and 90° knee flexion (depends on the pre-operative levels) • Improvement of the gait pattern • Improvement of the weight-bearing on the surgery side • Improvement of balance • Improvement of the neuromuscular function of quadriceps and gluteus maximus	• Postural exercises while sitting and standing • Closed kinetic chain exercises for quadriceps, hip abductors, and hamstring muscles • AA knee flexion–extension exercises while sitting • Gentle stretching for gastro-soleus muscles • Patellar mobilization • Hip abduction while standing or side-lying
Weeks 4 to 12	• Normal gait pattern • Progression of ROM exercises • Progression of hip abduction and adduction exercises • Gait training on soft surfaces • Balance and proprioceptive exercises	• Treadmill walking • Heel strike, toe-off exercises • Bridge exercises • Terminal knee extension • Open kinetic chain exercises in different knee ranges such as 90°-60°-45°etc. • Proprioceptive neuromuscular facilitation (PNF) techniques • Hip strengthening exercises with ‘TheraBand’ • Side walking • Proprioceptive exercises • Exercises on balance board