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The “HÄMOFIT”-project: exercise for adult male patients with severe haemophilia in Austrian fitness centres
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Veröffentlicht: | 24. Oktober 2011 |
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Objective: Aim of this pilot study was to test feasibility of strength training and flexibility exercises for adult male patients with severe haemophilia in fitness centres, the so called “HÄMOFIT”-project.
Material/Methods: This pilot study was performed in cooperation with the Austrian society of haemophilia (“HÄMOFIT”-project). After instruction by fitness trainers, 14 male patients with severe hemophilia performed strength training and flexibility exercises.
14 patients underwent baseline assessment, and 7 patients (50%, 30±8a, BMI=23±4 kg/m²) returned to follow up after 20(±10) months.
Frequencies of joint bleedings, number of painfully affected joints were assessed. Range of movement (ROM) of knees and elbows were recorded. Flexibility (0=no shortening, 1=moderate shortening, 2=severe shortening) of quadriceps muscles and pectoral muscles, and strength (KG0=no activity, KG1=noticeable activity, KG2=visible activity after compensation of gravity, KG3=activity against gravity, KG4=reduced strength against resistance, KG5=normal strength against resistance) of long trunk extensors and trunk flexors were assessed according to muscle test battery of Janda et al..
Results: Observed effects of the described exercise program (“HÄMOFIT”-project):
None of the patients showed side effects. Frequency of joint bleedings did not change.
The number of painful affected joints did not change or decreased.
There were no change of ROM of right elbow [0-26(±31)°-129(±21)°, mean] at follow up (for any patient). ROM of left elbow decreased slightly [0-9(±12)°-143(±10)° - 0-9(±12)°-140(±13)°, mean]. For patient 6, flexion of left elbow decreased by 15%.
There no change of ROM of both knees (for any patient): right knee: mean=0-4(±9)°-117(±13)°; left knee: mean=0-4(±8)°-116(±16)°.
Muscle strength of long trunk extensors and trunk flexors did not change for the whole group (KG4±1 – KG4±1, range). Nevertheless, muscle strength of long trunk extensors improved in 2 patients (patient 3: KG3 – KG4, patient 6: KG3 – KG4) and did not change in the other patients (KG3 – KG5, range).
Muscle strength of trunk flexors improved in patient 4 (KG4 – KG5) and did not change in the other patients (KG4 – KG5, range).
Flexibility of pectoral muscles and of right quadriceps muscles did not change for the whole group: right pectoral muscle: mean=0±0 – 0±0; left pectoral muscle: mean=0±0 – 0±0; right quadriceps muscle: mean=1±1 – 1±1. Nevertheless, patients 4, 5, 7 improved flexibility of right pectoral muscle (1–0, range); patients 1, 5 improved flexibility of left pectoral muscle (1–0, range). Patients 1, 2 improved flexibility of right quadriceps muscle (2–1, range). Flexibility of left quadriceps muscle improved for the whole group: mean= 2±1 – 1±1.
Conclusion: Strength and flexibility exercise in fitness centres seems to be feasible in patients with severe haemophilia. The results of this pilot observation indicate that severity of joint damage does not increase after such s strength and flexibility exercise-program. However, some patients were able to increase muscle strength of long trunk extensors and trunk flexors. Furthermore, some patients could improve flexibility of quadriceps muscles and pectoral muscles.