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An institutional pilot study to investigate physical activity patterns in boys with haemophilia
V Bouskill1,2, P Hilliard3, S Stephens4
1Department of Paediatrics, Division of Haematology/Oncology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada. vanessa.bouskill@sickkids.ca.
Insights
Children with severe hemophilia (a bleeding disorder) spend more time in sedentary activities as they age, unlike those with mild/moderate hemophilia. Prophylaxis may enable similar moderate to vigorous physical activity (MVPA) levels across severities.
Area of Science:
- Pediatrics
- Sports Medicine
- Hematology
Background:
- Hemophilia is a bleeding disorder often causing musculoskeletal bleeding, particularly in joints and muscles, potentially limiting physical activity participation in children.
- Understanding physical activity profiles in children with hemophilia is crucial for managing bleeding risks and improving quality of life.
Purpose of the Study:
- To compare the quantity, type, and intensity of physical activity using accelerometry in boys with different severities of hemophilia.
- To investigate the relationship between hemophilia severity and physical activity patterns in pediatric populations.
Main Methods:
- A prospective, cross-sectional, observational study involving 66 males with hemophilia.
- Participants wore accelerometers for one week and completed validated self-report questionnaires (PedHAL, 3DPAR).
- Physical activity was categorized into sedentary, light, moderate, or vigorous levels based on accelerometer data.
Main Results:
- Boys with severe hemophilia spent significantly more time in sedentary activities compared to those with mild/moderate hemophilia.
- Sedentary time increased with age in the severe hemophilia group, while it decreased with age in the mild/moderate group.
- Despite differences in sedentary time, prophylaxis may allow similar moderate to vigorous physical activity (MVPA) levels across hemophilia severities.
Conclusions:
- Prophylaxis in severe hemophilia may enable comparable engagement in moderate to vigorous physical activity (MVPA) to mild/moderate hemophilia.
- Increased sedentary behavior with age in severe hemophilia could be linked to developing arthropathy and psychosocial factors.
- Further research is needed to fully elucidate the complex interplay between hemophilia severity, physical activity, and long-term health outcomes.
Introduction:
Haemophilia is a bleeding disorder characterized by musculoskeletal bleeding. Trauma-induced bleeding into joints and muscles may be associated with participation in physical activities. Recognizing this, persons with haemophilia may limit physical activities to avoid bleeding. The characterization of physical activity profiles (type, intensity, frequency and duration) in children with differing severities of haemophilia has not been well documented. This is required to better understand the relationship between physical activity and bleeding in children with haemophilia.
Aim:
This study was a prospective, cross-sectional, observational study to compare the quantity, type and intensity of physical activity as measured by accelerometry in boys with different haemophilia severities.
Methods:
Subjects wore an accelerometer daily for 1 week and completed validated self-report PedHAL and 3DPAR questionnaires. Accelerometer activity levels were classified as sedentary, light, moderate or vigorous.
Results:
A total of 66 males were enrolled, 24 had mild/moderate and 42 had severe haemophilia. Subjects average age was 11.52 years (±3.99) and their average BMI was 20.74 kg m(2) (±5.68). Boys with severe haemophilia reported significantly more time per day spent in sedentary activities compared to those with mild/moderate haemophilia. Furthermore, the amount of time engaged in sedentary activities increased with age in those boys with severe haemophilia, whereas the opposite was true in those with mild/moderate haemophilia.
Conclusion:
We speculate that prophylaxis in children with severe haemophilia permitted them to engage in similar amounts of moderate to vigorous physical activity (MVPA) as children with mild/moderate haemophilia. Increasing sedentary time in the severe cohort with age may be attributed to increasing arthropathy among other psychosocial factors.
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