A new literature review has reported that people with hemophilia have reduced exercise capacity compared to healthy individuals, as measured by the 6-minute walk test (6MWT) and peak/maximal oxygen consumption (VO2max) reference values.

The review, published in Haemophilia, concludes that these patients also have a lower tolerance for exercise and increased musculoskeletal impairment compared to healthy individuals.

“Exercise capacity has been established as a protective factor against joint impairment in people with hemophilia. However, little is known about how exercise capacity is affected,” the authors wrote. “The principal aim of this review was to examine standardized laboratory or field tests used to assess exercise capacity in children, adolescents, and adults with hemophilia.”

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The research team conducted a systematic review and analysis of 19 studies from January 1990 through April 2022 that assessed exercise capacity among 825 patients with hemophilia. Fourteen studies used the 6MWT to assess exercise capacity, 6 used cardiopulmonary exercise testing, and 1 used Cooper’s oxygen uptake tests.

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The results of the analysis showed that people with hemophilia consistently had 6MWT values below the reference values reported for healthy individuals. In addition, they found reduced VO2max values in children and adults with hemophilia. These results imply that people with hemophilia overall have a poorer tolerance for exercise and greater musculoskeletal impairment than healthy individuals.

People with hemophilia are at high risk of chronic illness and a sedentary lifestyle, reducing their functional capacity and further complicating their efforts to participate in regular physical activity.

Adults and children with hemophilia can participate in physical activity and sports at similar rates as members of the general population with appropriate prophylaxis and expert supervision, and such participation can prevent and slow the progression of joint diseases, the authors wrote. Based on the results of this review, the authors recommend improvements in exercise capacity assessment and individualized exercise programs for PWH.


Cruz-Montecinos C, Núñez-Cortés R, Vasconcello-Castillo L, et al. Exercise capacity in people with haemophilia: a systematic review. Haemophilia. Published online July 27, 2022. doi:10.1111/hae.14646