Body Weight, Exercise, and Treatment of Hemophilia

Body Weight, Exercise, and Treatment of Hemophilia

Children with hemophilia usually begin prophylactic factor replacement therapy early in life. To stay healthy, they must follow their doctors' directions for replacement therapy carefully and completely. Part of that challenge is learning to infuse factor replacement therapy at home and sticking with their treatment plan.

A recent study of 10,814 boys and men with hemophilia (age, 6 to 79 years) recorded their weight and their use factor replacement therapy at home. About half of these patients were overweight or obese—not unlike the general population of the United States. Approximately 70% of these patients received factor replacement therapy at home, and 44% of them gave themselves infusions. Overweight or obese patients were 20% to 30% less likely to receive factor replacement therapy at home than were patients of normal weight. Likewise, teenagers and adults who were overweight or obese also were 20% less likely to give themselves infusions of replacement factor.

What Does This Mean for People With Hemophilia?

Increased fat in the arms and other body areas may make it difficult for patients to find a suitable vein for factor replacement therapy or give themselves infusions. Consequently, overweight and obese people with hemophilia may have trouble adhering to a prophylactic treatment schedule or injecting replacement factor quickly to stop a bleeding episode. As a result, they may have more medical problems related to their hemophilia.

In the past, children with hemophilia were encouraged not to engage in sports or other physical activity so that they had less of a chance of hurting themselves and bleeding. However, active individuals with hemophilia have not developed more joint bleeding and other problems than have inactive patients, but they have had to pay close attention to their prophylactic factor replacement schedule. Physicians now encourage persons with hemophilia to be more active to keep their body weight down, prevent bleeding episodes, and keep their joints limber and muscles strong.

Some sports are safer for people with hemophilia than are others. On the whole, contact sports can be especially dangerous. Low-impact sports such as swimming, snorkeling, archery, tai chi, golf, walking, and hiking tend to be excellent activities for people with the disease who need to exercise more and enjoy participating in sports. You may be able to try other sports as well, depending upon your age and physical condition; speak with your doctor first. The National Hemophilia Foundation has an excellent guide to physical exercise and sports that are safe for people with hemophilia. The guide, Playing It Safe: Bleeding Disorders, Sports and Exercise, may be downloaded from the National Hemophilia Foundation's website here:

www.hemophilia.org/NHFWeb/Resource/StaticPages/menu0/menu2/menu35/menu204/PlayingItSafe.pdf.

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