Sports in People with Hemophilia – Possible and Safe
Active involvement in sports and an active lifestyle are important aspects of daily functioning for people with hemophilia. Modern treatment of this disease, including the prophylactic administration of concentrates of the missing coagulation factor, has led to an increase in the number of very active patients. Numerous studies have confirmed that they are as physically active as the general population, although some emphasize that this is more relevant to children and young people. Therefore, the work of Dutch and Swedish authors focused on examining the relationship between age and physical activity in hemophiliacs, especially with regard to more intensive and riskier sports.
Methodology and Study Progress
Sweden and the Netherlands were deliberately chosen for the study because the prophylactic treatment differs between the two countries. In the Netherlands, medium-dose prophylaxis is used, whereas in Sweden, it involves relatively high dosing prophylaxis.
During the study, hemophiliacs were given questionnaires about sports activity (type and frequency of sport during the week), physical abilities (evaluated by the SF-36PF questionnaire: ranging from 100 to 0), joint condition (using the HJHS score – Hemophilia Joint Health Score), and possible limits of sport and physical activity. Sports were categorized by bleeding risk using recommendations from the National Haemophilia Foundation (5 categories, with the top 2 being designated as high-risk sports). Patients were assessed in age categories 18–22, 23–29, and 30–40 years, and their results were compared with the general population.
Study Findings
Questionnaires were completed by 71 adult patients with hemophilia (43 in the Netherlands and 28 in Sweden), with an average age of 26 years. All participated in sports activities, with 59% participating in activities classified as high-risk sports.
Among Dutch participants, a significant age-related decline in sports participation was observed (7 times per week in those aged 18–22 vs. 2 times per week in those aged 30–40; p < 0.05), as well as changes in HJHS scores (median 2.0 vs. 15.5; p < 0.01) and physical abilities (SF-36PF with a median of 100 vs. 77.5; p < 0.01). This age-related dependence was not observed in the Swedish cohort.
A very important finding was that sports activity was not associated with bleeding.
Conclusion
The authors state that all study participants were engaged in sports, with nearly two-thirds participating in high-risk activities. Dutch participants with medium-intensity prophylaxis exhibited a subsequent decline in sports participation and joint health and physical performance parameters with age. This was not observed in the group of patients with higher-dose prophylaxis.
The study results support the findings on the safety of sports activities for people with hemophilia using modern prophylaxis. According to the authors, it is important to focus on prospective studies evaluating potential sports-related injuries in hemophiliacs in the future.
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Source: Versloot O., Berntorp E., Petrini P. et al. Sports participation and physical activity in adult Dutch and Swedish patients with severe haemophilia: a comparison between intermediate‐ and high‐dose prophylaxis. Haemophilia 2019; 25 (2): 244–251, doi: 10.1111/hae.13683.
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