The Importance of Sports and
Exercise for People with
Haemophilia
John Stack, CSCS
info@summerfieldhealthandfitness.com
Importance of Physical Movement
Humans, by design, are meant to be active!
Need to start young
A huge amount of physical development occurs in the first
few years of life.
“Give the boy until he is seven and I will give you the man”
~ Jesuit maxim
Youth Physical Development Model
AKA Play
Games
FUN
Fundamental Movement Skills
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Running
Climbing
Rolling/Tumbling
Jumping/Skipping/Hopping
Swinging (either yourself or an object)
Bounding
Dodging/Change of Direction
Catching/Throwing
Static Balance
The modern child
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Effects of Obesity
Plus for PWH:
• Weak/soft
muscles
• Lack of tone
• Greater load on
joints
greater chance
of bleeds
It’s important to maintain a normal weight
range.
Exercise and PWH
• Common knowledge that exercise benefits
us all
• Haemophilia has previously severely
limited how active an individual could be
• Current innovations in treatment, safety
and preventative care have opened up the
world of sports and exercise …
• PWH now encouraged to engage in
physical activity
• All sports carry some degree of risk
• But the physical, social and psychological
benefits often outweigh the risks*
• Sports are important for the development
of self-esteem and enhanced confidence,
especially during adolescence
– Team sports particularly effective.
National Haemophilia Foundation, Haemophilia,
Sports and Exercise, 1996
• Athletic activities encourage children to learn
good judgement and become more independent
• Improved assertiveness and independence in
children result in marked clinical improvement
with fewer spontaneous bleeding episodes
Recommendations for Kids
• i.e. < 12 years old
• 60 - 90 minutes MINIMUM per day,
comprising:
– General physical activity (walking to school, free
play, etc.)
– Fundamental movement skills
– Sports practice
• Limit screen time
Adolescent PWH
Adolescent PWH
• Need to continue their sporting activities and be
active generally
• Sporting LEVEL will increase (i.e. become more
competitive, physical, etc.
• Needs to develop strength and muscle mass
– Developed through strength training
• Strength training can improve quality of life
• Strength training can prolong a sporting ‘career’
regardless of level at which it’s played.
Scientific Support for Strength Training
Green and Strickler, 1983
Increased strength, flexibility and joint stability gained from
strength training reduces the frequency of joint bleeds for
people with Haemophilia
Koch, et al, 1984
Exercise causes a transient increase in clotting factor levels
for people with mild and moderate haemophilia
Titkinsky (2002)
Data supports the use of resistance training for reducing
the frequency and severity of bleeding episodes
Souza at al (2012)
• Concluded that exercise can improve several outcomes
of quality in people with Haemophilia
• Referred to the improvement in blood coagulation
mechanisms as a result of exercise
Gonzalez et al (2007)
Authors highlight the need for increasing muscular power
through resistance training to address particular
weaknesses
Pietri (1992)
Suggested that strength training be commenced early in
the rehabilitation of joints after acute haemarthrosis
Hilberg et al (2003)
‘strongly’ recommend that specialised sports therapy be
included as an integral component of the complete training
regimen of haemophilic subjects
Overall conclusion from research is that
exercise, including strength training, is
hugely beneficial essential to people with
Haemophilia
©2012 Summerfield Health and Fitness
Benefits of Resistance Training
• A closely supervised, well-designed
strength training programme :
– Increases strength
– Prevents muscular atrophy
– Contributes to motor development, skill
mastery, feelings of competence and
achievement and athletic success
– Reduces the risk of sports related injury
– May help to reduce the frequency of bleeding
episodes
©2012 Summerfield Health and Fitness
Essential considerations
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Programme must be well designed and supervised
Programme must complement other sporting activities
Person must learn proper exercise technique
Exercise selection must account for any limitations the
PWH may have (e.g. joint replacement, target joints,
etc.)
• Poor exercise technique will cause as many problems
as not exercising at all
• Moderation is key
Recommendations for Adolescent
PWH
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Be physically active every day
Play a sport 3 – 4 days a week
Strength train 2 – 3 days a week
Eat to support your lifestyle
Exercise and the Adult PWH
• Longer life expectancy now.
• Quality of life v Quantity of Life
• Holy grail of health
– Maintain/Improve Muscle mass
– Retain joint mobility/range of motion
– Maintain/enhance strength
Case Study
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Charlie
Aged 71
Has an under 21s county medal in GAA
“Recreational” cyclist
Started strength training summer 2014
Results:
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‘First man home’
Stronger
More mobile
Improved quality of life
• Less pain
• Less stiffness
• More energy
The Incapacitated PWH
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Everything previously said works as long as he can exercise
What if he cannot comfortably exercise?
He still needs to strive to be healthy/maintain weight
Inactivity destroys a body.
How can he work around a target joint?
Once he is cleared by medical team/physios:
– Physical Therapy
– Aqua-exercise
• Swimming
• Resistance training in a pool
– Possible to train around the target joint
• e.g. train the upper body if target joint is in the lower limb, etc.
Summary
• Physical activity is essential for PWH
• Kids need to be active every day so that they
can develop FMS, maintain a normal body
weight, and be healthy
• Adolescents (and adults) should supplement
their physical activity with strength training
• People who are incapacitated must be helped
to find a way to be active
Thank you.