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Moderate-intensity exercise improves the thromboelastography coagulation index in children with severe hemophilia A

Kui-Xing Li1, Juan Xiao, Yong-Qiang Zhao

  • 1aDepartment of Hematology bDepartment of Pediatrics cClinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China dDivision of Hematology/Hematologic Malignancies, Department of Medicine, University of Calgary-Foothills Hospital, Calgary, Alberta, Canada eDepartment of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China.

Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis
|December 15, 2015
PubMed

Insights

Moderate-intensity exercise may improve blood clotting in children with severe hemophilia A. This pilot study found enhanced global hemostatic function after exercise, with no adverse events reported.

Area of Science:

  • Pediatric Hematology
  • Exercise Physiology
  • Hemostasis and Thrombosis

Background:

  • Severe hemophilia A is a genetic bleeding disorder characterized by deficient factor VIII (FVIII) activity.
  • Understanding the impact of physical activity on hemostasis in children with hemophilia A is crucial for optimizing management.

Purpose of the Study:

  • To investigate the effects of moderate-intensity exercise on FVIII activity and global hemostatic status in children with severe hemophilia A.

Main Methods:

  • A pilot study involving 11 children (aged 6-15 years) with severe hemophilia A who underwent a moderate-intensity exercise test.
  • Blood samples were collected pre- and post-exercise to analyze plasma FVIII:C and thromboelastography (TEG) parameters, including coagulation index.
  • Exercise duration averaged 11.8 minutes, with no reported bleeding events or adverse symptoms.

Main Results:

  • While FVIII activity showed a non-significant increase post-exercise (0.66 to 0.93 IU/dL), TEG analysis revealed significant improvements in global hemostatic function.
  • Key TEG parameters such as R-time, K-value, alpha angle, maximum amplitude, and coagulation index showed significant changes indicating enhanced clotting.
  • A relative increase in coagulation index greater than 50% was observed in 63.6% of participants.

Conclusions:

  • Moderate-intensity exercise appears to enhance global hemostatic function in children with severe hemophilia A.
  • Exercise interventions may be a safe and beneficial adjunct therapy for managing hemophilia A in pediatric populations.
  • Further research with larger cohorts is warranted to confirm these findings and establish exercise protocols.

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