Muscle thickness and pennation angle in overweight persons with moderate haemophilia A after resistance and combined training: A randomized controlled trial

Abstract

Introduction Muscular atrophy and overweightness develop arthropathy in persons with haemophilia (PWH), and exercise increases their muscle strength and decreases their body weight. Musculoskeletal ultrasonography may be a non‐invasive, safe, valid, and reliable tool to investigate muscle thickness (MT) and pennation angle (PA) after exercise training. Objectives The present study was conducted to evaluate the effects of 6 weeks of resistance training (RT) and combined resistance and aerobic training (CT) on MT and PA in overweight persons with moderate haemophilia A. Materials and methods Forty‐two persons with moderate haemophilia A with a mean age of 35–55 years and a BMI of 25–30 kg/m2 were randomly assigned to three groups of 14, namely RT, CT, and control. The RT group performed 40 minutes of RT, and the CT group performed 20 min of RT and 20 min of aerobic training. The PA and MT of the biceps brachii (BB), triceps brachii (TB), vastus medialis (VM), vastus lateralis (VL), and medial gastrocnemius (MG) were measured before and after the intervention using B‐mode ultrasonography. Results Significant increases were observed in the MT of VM, VL, MG, BB, and TB and PA of VM, VL, and MG in the RT and CT groups compared to the control group (p < .001). No significant differences were observed between the intervention groups. Conclusion Both RT and CT were effective in enhancing MT and PA in overweight persons with moderate haemophilia A.

Exercise variables and pain threshold reporting for strength training protocols in people with haemophilia: A systematic review of clinical trials

“…Finally, full‐text articles were retrieved and, after applying the eligibility criteria, 18 studies remained to be included in this systematic review (Figure 1). 20–37 …”

“…Of the total number of articles selected, 12 were from Europe, five from Asia and one from Oceania (Table 1). Only four studies evaluated the effect of isolated strength training, 27,33,34,37 while the rest of the interventions combined muscle strengthening with other modalities such as manual therapy, 24,26,31,32,35 balance training, 20,21,25 coordination and mobility, 23,[28][29][30] flexibility, 25,26,31,32 psychological intervention 36 and aerobic exercise. 22…”

Effects of Physical Therapy on Joint Pain, Joint Range of Motion, Joint Health, Strength, and Mobility in Patients With Hemophilia

“…In the study by Parhampour et al, 18 the intensity of resistance training was set at 65% 1RM in the first 2 wks, 70% 1RM in the second 2 wks, and 75% 1RM in the third 2 wks. The intensity of combined aerobic exercise and resistance training 18 was adjusted at 65%, 70%, and 75% of maximum heart rate in the first, second, and third 2 wks for aerobic exercise; and 65% 1RM in the first, 70% 1RM in the second, and 75% 1RM in the third 2 wks for resistance training, during the 6 wks. This suggests that resistance training played an important role to enhance muscle strength in patients with hemophilia.…”

“…The three exercise types were moderate-vigorous elastic resistance training, 11 resistance training, 18 and combined aerobic exercise and resistance training. 18 In the study by Calatayud et al, 11 the intensity of moderate-vigorous elastic resistance training started from 20 repetition maximum (RM) and increased at an interval of every 2 wks to higher intensities of 15RM, 12RM, and finally 10RM during the eighth week. In the study by Parhampour et al, 18 the intensity of resistance training was set at 65% 1RM in the first 2 wks, 70% 1RM in the second 2 wks, and 75% 1RM in the third 2 wks.…”

“…Reviewing past literature, patients with hemophilia were encouraged to perform physical therapy because of several studies that demonstrated the benefits of physical therapy in decreasing joint pain, 4–8 and increasing joint range of motion, 4,7,9–12 joint health, 6,13–16 mobility, 9,11,17 and muscle strength 11,18 . However, to the best of our knowledge, no systematic review with meta-analysis comprehensively summarizes the effects of physical therapy in patients with hemophilia.…”