Related Experiment Video
Updated: May 20, 2025
Lower Limb Biomechanical Analysis of Healthy Participants
Published on: April 15, 2020
Physical activity and handgrip strength in patients with mild, moderate and severe haemophilia: Impacts on bone
Pia Ransmann1, Marius Brühl2, Jamil Hmida2
1Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany.
Background:
Patients with haemophilia (PwH) might be restricted in physical activity (PA) depending on the severity phenotype. It is well-known that PA affects overall health including bone quality. This study aims to evaluate the level of PA within the different haemophilia severity phenotypes and to elaborate on the interplay of PA in regard to bone quality (bone mineral density (BMD) and trabecular bone score (TBS)) as well as lean mass.
Methods:
This investigation was part of a large prospective single-center cohort study examining the relation between haemophilia and osteoporosis registered at clinicaltrials.gov (ID: NCT04524481). PwH underwent a dual x-ray screening using Horizon™ to examine BMD, TBS, and lean mass. Step activity was tracked electronically for seven consecutive days after clinical examination, supported by a self-reported activity diary for seven days. Handgrip strength was examined as an overall fitness proxy.
Results:
Data of 223 patients with either mild (N = 45), moderate (N = 46), or severe (N = 132) haemophilia A or B, aged 43.6 ± 15.6 years were analyzed. There was no significant difference in objective (p = 0.162) and subjective (p = 0.459) PA levels between severity phenotypes. The most frequent type of PA in all severities was walking (n = 72, 53.3%) and cycling (n = 60, 44.4%). Step activity positively correlated with TBS (rho = 0.202, p = 0.005) and lean mass positively correlated with BMD (rho = 0.309, p < 0.001). Handgrip strength correlated with BMD (rho = 0.361, p < 0.001) as well as TBS (rho = 0.221, p = 0.021) and lean mass (rho = 0.287, p = 0.003).
Conclusion:
PA does not differ significantly between the severity phenotypes. The majority of PwH in all severity phenotypes performed low-impact PA, which is most likely insufficient to positively affect BMD. However, handgrip strength correlates with BMD and TBS. Despite restrictions in movement function or reduced BMD, it is of major importance to promote PA to maintain a healthy or even increase bone quality.
More Related Videos
Related Concept Videos
01:29Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
01:27Exercise and Muscle Performance
Endurance exercises
Endurance exercises involve running, swimming, or cycling, which require repetitive movements with low force output. When a person engages in endurance exercise, a few noticeable changes occur in their skeletal muscles. For instance, the number of capillaries...
01:17Exercise and Cardiac Output
Sustained exercise increases the muscles' oxygen demand, which can be...
01:20Exercise and Cardiovascular Response
Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...
01:25Role of Vitamins in Maintaining Bone Health
Vitamin A
Vitamin A is involved in the process of bone remodeling. Retinoic acid, the active metabolite of Vitamin A, has nuclear receptors in osteoblasts and osteoclasts, which are involved in bone remodeling.
Vitamin B12
Vitamin B12 acts as a cofactor during the formation of osteoblast-related proteins, such as osteocalcin. Vitamin B12 plays a role...