Similar sports participation as the general population in Dutch persons with haemophilia; results from a nationwide study

Abstract

Introduction Although sports participation is advocated in people with haemophilia (PWH), detailed data concerning sports participation in Dutch PWH is lacking. Aim to assess sports participation in Dutch PWH (6‐65 years) compared to the Dutch general population (GP). Methods Data from a nationwide, cross‐sectional study in PWH were analysed. Sports participation (type, duration, frequency) was assessed by the Modifiable Activities Questionnaire (MAQ), limitations in activities using the (Paediatric) Haemophilia Activities List ((Ped)HAL). Sports in the two highest categories according to the National Hemophilia Foundation classification were considered high‐risk sports. Groups were compared using Chi‐square testing. Results A total of 524 Adult PWH (median age: 45 (IQR: 30–55); 37% severe) and 126 paediatric PWH (median age: 11 (IQR: 8–14); 52% severe) were included. Sports participation was higher in adults (70%) than the GP (58%) and similar to the GP in children (PWH: 68%, GP: 72%). High‐risk sports participation decreased with age in PWH: from 65% (6‐12 years) to 17% (50‐65 years), which was also observed in the GP. Sports participation in children was independent of severity (non‐severe: 67% vs. severe: 65%; P = 0.97), but not in adults (non‐severe: 75%, severe: 62%; P < 0.01). Non‐severe PWH played more high‐risk sports than severe PWH: children at 65% vs. 48% (P = 0.05), adults at 25% vs. 15% (P = 0.07). Discussion These results suggest that sports participation in PWH was comparable to the GP. Sports participation was dependent of haemophilia severity in adults. Children were more involved in high‐risk sports than adults. More studies on sports‐related injury‐risk are needed for adequate counselling.

Exercise capacity in people with haemophilia: A systematic review

“…51 Early and appropriate prophylaxis and expert guidance of physical exercise programmes are necessary to promote and improve physical capacity in PWH. 52,53 When these conditions are present, physical activity and sports participation in PWH can be similar to that of the general population in both children 54,55 and adults. 56 The promotion of physical activity can be considered as a low-cost intervention that can prevent and reduce the progression of joint diseases and should be prescribed to obtain multiple physical and psychological benefits in PWH.…”

Promoting physical activity for people with haemophilia in the age of new treatments

“…Notably and encouragingly, it seems that those younger adult PWH using long-term prophylaxis and/or exhibiting a mild/moderate bleeding phenotype who have a supportive social environment are as active as their healthy peers. [39][40][41] In the general adult population, health status and self-efficacy are the most important individual factors for being physically active, followed by previous PA and intention to exercise. 21 Younger age, male sex, social support, education level, ethnic origin, not being overweight, low perceived effort of PA, availability of recreation facilities, transportation environment, and aesthetic pleasantness of the environment are other factors associated with PA for adults.…”

“…There is, however, presumably a spectrum of PA levels within this broad age category, reflecting various life situations, functional levels and heterogeneous perceptions of PA. Notably and encouragingly, it seems that those younger adult PWH using long‐term prophylaxis and/or exhibiting a mild/moderate bleeding phenotype who have a supportive social environment are as active as their healthy peers 39–41 …”

Exploration of the minimum necessary FVIII level at different physical activity levels in pediatric patients with hemophilia A

“…Each increment of 1% in the FVIII level with treatment before sports correlates with a decreased bleeding risk by 2% ( 5 ). Compared to patients with severe hemophilia, non-severe type patients had higher participation in high-risk sports (65% vs. 48%, p = 0.05) ( 24 ). In this study, we explored the minimum necessary FVIII level during different physical activities.…”