Haemophilic arthropathy of the ankle causes pain and deterioration in gait, causing disability. Although some physiotherapy modalities are effective in the management of acute bleeding, the results are unknown in chronic arthropathy. Our objective was to determine the most effective physiotherapy procedures for treating the haemophilic arthropathy of the ankle and to assess the methodological quality of the studies. A systematic review was carried out in the Cochrane Database, PubMed, MEDLINE, ISI Web of Knowledge, PEDro, TESEO, and specialized journals (Haemophilia and Haematologica). It included articles with at least one group undergoing any kind of physiotherapy treatment and with pretest and posttest evaluation, published before April 2013. An analysis of variables was performed and assessed the methodological quality of studies. Five studies met the criteria for inclusion. Hydrotherapy treatments, strength training and balance strength, balance training, and sports therapy, have improved range of movement, pain, balance, and subjective physical performance. The proposed methodological analysis was not possible due to the low quality of the studies. Although the results are positive, they lack rigorous evidence on the effects of treatments. Studies are needed to establish the efficacy of the various forms of physiotherapy in the haemophilic arthropathy of the ankle. 1. Introduction Hemophilia is a blood-clotting disorder caused by a deficiency in factor VIII (FVIII) or factor IX (FIX), which manifests itself through bleeding in the muscles and joints [1]. There are three categories, depending on the percentage of the blood-clotting factor: severe hemophilia (<1% FVIII/IX), characterised by spontaneous bleeding; moderate hemophilia (1–5% FVIII/FIX), with bleeding from slight injuries; and mild hemophilia (>5–40% FVIII/FIX) with bleeding during surgical procedures or from severe injuries [2, 3]. Eighty percent of the episodes in hemophiliac patients involve bleeding in the joints, or haemarthrosis [4, 5], with the ankle being the third most frequently affected joint [6]. The symptoms of intra-articular ankle bleeding are severe pain, limited range of motion, inflammation, and synovial involvement. Without proper treatment, capsular and tendon contractures can develop in the joints [7]. Although experiments on animals cannot be directly related to the humans, Hooiveld et al. [8] observed in a canine model that weight-bearing joints, as opposed to non-weight-bearing joints with haemarthrosis, suffered progressive and degenerative damage after a
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