The ability/willingness of patients with hemophilia to participate in physical activity is partly influenced by external variables, such as the attitudes of friends, family, and healthcare professionals, according to a study published in Haemophilia. 

Studies indicate that patients with hemophilia have a lower exercise capacity than their healthy peers. This may lead to a sedentary lifestyle, fueling physical dysfunction and obesity. The cause of lower levels of physical activity are often thought to be solely due to a patient’s own attitudes and abilities, but studies suggest that the real reasons may be more nuanced and multifaceted. 

The authors of the study sought to investigate perceived barriers to physical activity in patients with hemophilia to encourage participation. They conducted an explorative qualitative study based on 4 focus groups with patients with severe hemophilia A. During the focus group meetings, participants were encouraged to share their perceived barriers to physical activity in a candid fashion. In addition, they were asked to fill in questionnaires on demographics, clinical data, and perceived health. 

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The research team focused on a number of themes during these focus group sessions. Among them were attitudes and perceptions on physical activity, ie, aspects of physical activity that patients were familiar with and reasons for participating and not participating. Researchers also explored patients’ experience with physical activity, which included recommendations for physical activity, the relationship between treatment and physical activity, and any complaints about participation. They also explored motivational factors, social/personal influences, and accessibility to exercise. 

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The research team recruited 16 participants to take part in the study. They reported a number of key findings. First, patients often felt more confident participating in physical activity if they had access to prophylaxis therapy. Second, although personal motivation often dictated participation in physical activity, support from family, friends, and healthcare professionals was seen as equally important. Third, participants described the presence of a physical activity facilitator, the ability to enjoy social interaction during exercise, and costs as factors influencing their decision to participate in physical activity. 

“It is critical that physicians provide tailored recommendations for engaging in physical activity and be up to date on the barriers and facilitators faced by [patients with hemophilia],” the authors concluded.


Cotino C, Pérez-Alenda S, Cruz-Montecinos C, et al. Barriers and facilitators of physical activity in adults with severe haemophilia: a qualitative studyHaemophilia. Published online July 19, 2023. doi:10.1111/hae.14828