Impact of aerobic exercise on haemostatic indices in paediatric patients with haemophilia

Kumar, Riten; Bouskill, Vanessa; Schneiderman, Jane E.; Pluthero, Fred G.; Kahr, Walter H.A.; Craik, Allison; Clark, Dewi; Whitney, Karen; Zhang, Christine; Rand, Margaret L.; Carção, Manuel

doi:10.1160/th15-09-0757

Cited by 18 publications

(25 citation statements)

References 49 publications

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“…With the aim to validate these results, we have now repeated the study in a larger cohort consisting of 10 persons with severe HA and 10 matched controls. We have also examined whether the increased levels of VWF after physical exercise seen in our previous study, as well as described by others, might prolong the effect of factor concentrate administered just before exercise.…”

Section: Introductionmentioning

confidence: 64%

“…Exercise has also been shown to increase levels of FVIII:C in healthy people as well as in patients with mild and moderate haemophilia A (HA). However, in patients with severe HA, no such increase has been shown …”

Section: Introductionmentioning

confidence: 97%

“…However, in patients with severe HA, no such increase has been shown. 9,11 The global coagulation assays thrombin generation assay-calibrated automated thrombogram (TGA-CAT) and rotational thromboelastometry (ROTEM) are thought to better represent the bleeding tendency than the measurement of individual coagulation factors, as they have been shown to correlate with the differences in clinical severity of HA observed in patients with the same FVIII levels. 12,13 There is some evidence, although conflicting, that the global function of the coagulation system increases during physical exercise in healthy subjects, 14 but has not been systematically evaluated in PWH.…”

Section: Introductionmentioning

confidence: 99%

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Coagulation factor VIII is vital for increasing global coagulation after physical exercise

et al. 2019

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Background In a previous smaller study, we found evidence of a diminished global coagulation capacity after maximal exercise in patients with severe haemophilia A (HA). Aim To validate these results, we repeated the study in a larger cohort. We also examined if the exercise‐induced increased levels of von Willebrand factor (VWF) might prolong the effect of factor concentrate administered just before exercise. Methods We studied individual and global coagulation parameters after maximal physical exercise in 10 persons with severe HA and 10 healthy matched control subjects. Blood samples were taken before, 10 minutes, 60 minutes and 4 hours after exercise. Results Rotational thromboelastometry (ROTEM) and thrombin generation assay‐calibrated automated thrombogram (TGA‐CAT) showed significantly increased coagulation capacity after maximal exercise in healthy controls but not in patients with severe HA. VWF antigen and activity levels increased significantly in both groups, whereas FVIII:C only showed a significant increase in the control group. No statistically significant differences were seen between FVIII pharmacokinetic results obtained with and without exercise. Conclusion Our findings do not support the presence of a FVIII‐independent mechanism that increases global coagulation, but rather underscores the importance of FVIII in mediating the increased coagulation capacity seen after exercise. Our results could not support the hypothesis that exercise‐induced increased levels of VWF for patients with severe HA lead to a prolonged effect of factor concentrate administered just before exercise.

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Section: Introductionmentioning

confidence: 64%

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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Coagulation factor VIII is vital for increasing global coagulation after physical exercise

et al. 2019

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“…Active children with hemophilia typically bleed less than their inactive/sedentary peers . With moderate to strenuous aerobic exercise, children with mild factor VIII deficiency can have a 2‐ to 2.5‐fold increase in baseline factor VIII levels …”

Section: Benefits Of Exercisementioning

confidence: 99%

“…25 With moderate to strenuous aerobic exercise, children with mild factor VIII deficiency can have a 2-to 2.5-fold increase in baseline factor VIII levels. 26,27 For patients with thrombosis, a systematic review of nine studies found that physical activity in adult patients with deep vein thrombosis (DVT) is overall beneficial. 28 Specifically, in the setting of an acute DVT, early exercise as compared with bed rest was associated with a more rapid resolution of limb pain and not associated with an increased risk of embolism.…”

Section: Benefits Of Exercisementioning

confidence: 99%

How I approach managing student athletes at risk for bleeding

Witmer

2018

Pediatric Blood & Cancer

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Frequently, pediatric hematologists need to provide guidance regarding sports participation for children with congenital coagulopathies, immune thrombocytopenia, and those receiving anticoagulation. Although sports participation has clear health and psychosocial benefits, it can be associated with harm secondary to bleeding from injury. Decision‐making for sports involvement should be individualized, patient centered, and well informed. This review focuses on the current data regarding the benefit as well as risks for sports participation and provides a framework for advising and supporting the student athlete who is at risk for bleeding.

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Constitutive hypercoagulability in pediatric sickle cell disease patients with hemoglobin SS genotype

Sussman,

Mburu,

Steele

et al. 2024

Research and Practice in Thrombosis and Haemostasis

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Impact of aerobic exercise on haemostatic indices in paediatric patients with haemophilia

Abstract: C levels with exercise. The greatest improvement in haemostatic indices was observed in post-adolescent males with mild-moderate HA, who thus represent the group most likely to benefit from a reduction of bleeding risk in the setting of exercise.

Cited by 18 publications

References 49 publications

Coagulation factor VIII is vital for increasing global coagulation after physical exercise

Coagulation factor VIII is vital for increasing global coagulation after physical exercise

How I approach managing student athletes at risk for bleeding

Constitutive hypercoagulability in pediatric sickle cell disease patients with hemoglobin SS genotype

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