Physical activity and joint function in adults with severe haemophilia on long-term prophylaxis

It has been shown that patients with severe haemophilia treated on demand are not as physically active as their healthy peers and often have a sedentary lifestyle that contributes to chronic joint disease. The use of prophylaxis provides opportunities for participation in physical activities with fewer bleeding episodes. The objective of the study was to describe the type, intensity and duration of physical activity among adult patients with severe haemophilia and to find out whether a joint function dependency exists. Patients with severe haemophilia, divided into two groups (group A: patients who started prophylaxis at the age of ≤3 years and group B: patients who started prophylaxis at the age of >3 years), and 190 controls were included. Physical activity was assessed using the self-report Modifiable Activity Questionnaire. Time involved and intensity of all aspects of physical activity for group A were almost similar to their healthy peers. Group B had significantly lower vigorous, leisure and total physical activities than group A and their healthy peers. Positive significant correlations were found between leisure and total physical activities and joint score in group A, whereas in group B, there was negative significant correlation between only nonweight-bearing activity and joint score. The early start of long-term, primary prophylaxis has been successful in reducing frequency of bleeds and thereby preventing or delaying subsequent chronic joint disease, and enables the patients to lead a physically normal life also during adulthood when patients with haemophilia treated on demand are expected to have substantial joint disease impacting their physical activity.