Physical Activity in Young Men with Hemophilia A
What may influence the inclusion of physical activity in the lifestyle of individuals with hemophilia? This was the focus of a Norwegian study published in the journal Haemophilia.
Introduction
Regular physical activity in hemophilia A is known to bring numerous benefits according to available evidence. However, it is known that physical activity is very complex and is influenced by individual, social, and other factors. It is therefore quite difficult to reliably determine whether the individuals in question are physically active or not. Various tools can be used to objectively measure the degree of physical activity, such as activity-tracking wristbands.
Assessed Patient Population
The aim of the Norwegian observational study was to assess the correlation of demographic parameters and hemophilia-related factors with objectively assessed physical activity in young men with hemophilia A (time in minutes spent in light, moderate, or intense physical activity, total daily physical activity time, weekly physical activity in line with WHO recommendations).
Data from the HemFitbit study, which included young men aged 13–30 years with moderate to severe hemophilia A on continuous prophylaxis, using Fitbit technology to monitor physical activity, were utilized. The analysis included 40 participants with an average age of 19.5 years.
Results
The annual bleeding rate approached 0 and joint scores were low among most participants. An increase in time spent in light physical activity with age was observed, at 4 minutes/day for each year of age.
Physical activity was also assessed based on joint health determined using ultrasound and the HEAD-US score (Haemophilia Early Arthropathy Detection with Ultrasound). It was found that participants with a HEAD-US score ≥ 1 performed, on average, 14 minutes/day less moderate and 8 minutes/day less intense physical activity compared with those who had no ultrasound-detected joint damage (HEAD-US score 0).
WHO recommendations for physical activity in hemophilia were met by all included adult men. The comparison was therefore made only among adolescents. Those who met the WHO guidelines had slightly better joint health (in terms of bleeding frequency and joint scores) compared to adolescents who did not meet these limits. Otherwise, the characteristics of adolescents meeting and not meeting the WHO criteria did not differ significantly.
Conclusion
In young individuals with hemophilia A on prophylaxis, light to moderate intensity physical activity increases with age. The findings of this analysis also indicate that the presence of mild arthropathy does not affect light physical activity but may influence moderate and higher intensity physical activity. Therefore, early initiation of effective prophylaxis may be a crucial factor influencing the future physical activity of individuals with hemophilia.
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Source: Matlary R. E. D., Grydeland M., Glosli H. et al. Factors associated with physical activity in young people with haemophilia A on prophylaxis. Haemophilia 2023 May; 29 (3): 900–909, doi: 10.1111/hae.14776.
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