09 March 2018
The NNHF Mexico 3 project started in 2015 with the objective of setting up paediatric rehabilitation in the two largest hospitals in the country providing haemophilia care for children.
To start, they teamed up with experts from other countries in Latin America, such as Dr Toribio Gómez, orthopaedist, and Naiari Fernández, physiotherapist from Venezuela as well as with Dr Laura Villareal, paediatric haematologist who led the NNHF Mexico 2 project in the Mexican State of Nuevo León. The training sessions intended to improve the skills of the local team providing also an opportunity to exchange and develop ideas for the implementation of the project.
The objectives identified by the NNHF Mexico 3 project team were:
· Train healthcare professionals on musculoskeletal (MSK) care
· Identify children with haemophilia with haemarthrosis and at risk of developing functional limitations
· Establish a rehabilitation programme and anchor it in the care approach
· Raise awareness amongst the haemophilia community of the importance of MSK care and prevention.
The project team identified two main streams of focus in order to achieve its objectives: developing educational material for children, families and their social environment and establishing the paediatric rehabilitation programme.
Engaging educational material tailored for children
To raise awareness about the condition and sensitise the community on the importance of MSK care and prevention, the project team developed a comprehensive set of educational materials, such as "Knowing my haemophilia", "Haemophilia exercise guide" addressing children and their families, and the triptych "Haemophilia and my school" that children could bring to their school teachers to explain their condition and improve their school adaptation.
The team produced also a patient diary where patients could mention, in addition to the general information, the multidisciplinary assessment that they required (e.g. psychology, orthopaedics, dental…) as well as track bleedings, including specification of the type of treatment.
To reach out to as many children with haemophilia as possible and encourage them to exercise at home, the project team developed the “My haemophilia” app for smartphones and tablets. The app provides information about haemophilia and how to exercise, in English and Spanish. Launched in September 2017, in only a few months it has been installed by more than 420 users worldwide.
Gaming as a way to increase treatment adherence
After identifying children with haemophilia with haemarthrosis or presenting a risk of developing functional limitation, the Mexico 3 project team designed an eight-week rehabilitation programme consisting of daily therapy at home and rehabilitation at the hospital.
What better way to motivate children to attend rehabilitation sessions at the hospital than designing a “playful” programme that comprises the use of video games?
The team had the idea of designing physiotherapy sessions using Xbox One Kinect and games such as “Sports rivals” at intermediate level, or “Just dance” to improve coordination, balance and proprioception.
In addition the project team engaged and empowered parents to take an active role in the rehabilitation programme, as they motivated their children to exercise at home and monitored their adherence to treatment.
To reach out to as many children with haemophilia as possible and encourage them to exercise at home, the project team developed the 'My haemophilia' app for smartphones and tablets. The app provides information about haemophilia and how to exercise, in English and Spanish. Launched in September 2017, in only a few months it has been installed by more than 420 users worldwide.
Thanks to the great collaboration between healthcare professionals from the two centres, international experts, children and their families, the NNHF Mexico 3 inclusive and innovative approach to paediatric rehabilitation has proven particularly impactful. All patients who have taken part in the rehabilitation programme have reported improved mobility and muscular strength, and as they enjoyed the playful approach they are keen to continuing exercising to improve their quality of life.
The team will share the impact of the project in a scientific publication and at the WFH Congress in May 2018, reporting the improvements in joint health for people with haemophilia and their increased adherence to rehabilitation treatment, achieved thanks to their playful approach.