title: The impact of sport on health status, psychological well-being and physical performance of adults with haemophilia.
abstract: BACKGROUND
  There is increasing recognition that sport is important for individuals with haemophilia; however, there remains a paucity of data of the importance of this in adults, many of whom already have joint pathology related to childhood bleeds and treatment access. This multicentre, cross-sectional study presents the impact of sport on health-related quality of life (HRQoL), physical performance and clinical outcomes in adults with haemophilia.
  
  
  RESULTS
  Fifty adults aged 35.12±14.7 with mild (n = 12), moderate (n = 10), or severe (n = 28) haemophilia A (70%) or B (30%) from four haemophilia centres across the United Kingdom participated in the study. A total of 64% were overweight/obese according to their BMI; median orthopaedic joint scores using the WFH Orthopaedic Joint Score (OJS) were 6 (range 0-48). On a VAS pain scale (range of 0-10), patients reported mean score of 5.66 ± 2.4. 36% of participants reported not doing any sport, mainly due to their physical condition. However, 64% of participants reported undertaking sporting activity including contact sports, mostly twice per week in average 4 h week(-1) . Participating in sport did not have a statistically significant impact on HRQoL; except in the domain 'sport and leisure' of the Haem-A-QoL. Patients doing more sport reported significantly better HRQoL than those doing less sport (P < 0.005). Those doing sport for more than 4 h week(-1) had a significantly better physical performance than patients doing less sport (assessed with Hep-Test-Q). Encouraging physical activity and sport in older patients with haemophilia may have a direct impact on their HRQoL; thus, education about sport activity should be incorporated into routine haemophilia care.
authors.affiliation: Institute of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: S
authors.initials: S
authors.lastname: von Mackensen
authors.affiliation: Katherine Dormandy Haemophilia Centre and Haemostasis Unit, Royal Free London NHS Foundation Trust, London, UK.
authors.forename: C
authors.initials: C
authors.lastname: Harrington
authors.affiliation: Katherine Dormandy Haemophilia Centre and Haemostasis Unit, Royal Free London NHS Foundation Trust, London, UK.
authors.forename: E
authors.initials: E
authors.lastname: Tuddenham
authors.affiliation: Haemophilia Centre, Royal Manchester Children's Hospital, Central Manchester Foundation Trust, Manchester, UK.
authors.forename: A
authors.initials: A
authors.lastname: Littley
authors.affiliation: Haemophilia Centre, Royal Manchester Children's Hospital, Central Manchester Foundation Trust, Manchester, UK.
authors.forename: A
authors.initials: A
authors.lastname: Will
authors.affiliation: University Dept of Haematology Manchester Royal Infirmary, Manchester, UK.
authors.forename: M
authors.initials: M
authors.lastname: Fareh
authors.affiliation: University Dept of Haematology Manchester Royal Infirmary, Manchester, UK.
authors.forename: C R M
authors.initials: CR
authors.lastname: Hay
authors.affiliation: Haemophilia Centre, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
authors.forename: K
authors.initials: K
authors.lastname: Khair
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D003430:Cross-Sectional Studies; D003710:Demography; D015444:Exercise; D006304:Health Status; D006467:Hemophilia A / Q000473:pathology / Q000523:psychology*; D006801:Humans; D007596:Joints / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D055585:Physical Phenomena; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: adults; haemophilia; health-related quality of life; physical performance; sport; sporting activity