Applying World Health Organization 2020 guidelines on physical activity and sedentary behavior to people with hemophilia

ABSTRACT

Introduction: The new World Health Organization (WHO) guidelines on physical activity incorporate new concepts, such as sedentary behavior, recommendations for specific age groups and for people living with chronic conditions and disability. This could be extrapolated for the first time to people with hemophilia (PWH) within the framework in which these recommendations are applicable. The benefits of physical activity for PWH include physical, psychological and social benefits.

Areas covered: This is a narrative review of the literature. We searched the MEDLINE and the Cochrane Library for WHO guidelines and articles related to physical activity in PWH. For all population groups, the benefits of performing exercise outweigh the possible harms. In PWH, there is a perceived increased risk of bleeding associated with physical activity. However, research suggests that this risk is associated with trauma during activity rather than intensity of physical activity, which offers the most health benefits.

Expert opinion: Given the hematological, physical and functional conditions of PWH are highly variable, individualized counseling is needed based on age, therapeutic strategy, degree of arthropathy and level of disability. In this article, we analyze the applicability of the WHO recommendations to PWH, which is important to further promote healthy lifestyle motivation.

KEYWORDS:

• Hemophilia
• physical activity
• efficacy
• world health organization
• guidelines

Article highlights

• The new World Health Organization (WHO) guidelines on physical activity and sedentary lifestyles includes for the first time people with chronic conditions and disabilities and therefore applies to people with hemophilia (PWH).

• Increased life expectancy, inactivity and obesity in PWH imply increased risk of cardiovascular disease and arthropathy. This risk can be alleviated with physical activity and by avoiding sedentarism.

• For all populations, including PWH, performing some physical activity is better than performing none. Moderate to vigorous activity offer the greatest health benefits, such activities may include household chores, walking to work and gardening.

• For PWH, individualized counselling is recommended for performing physical activity.

• Regular aerobic and strengthening activities should be undertaken. PWH benefit from adding balance, coordination, flexibility and functional activities.

• Physical activity should be encouraged at an early age, and self-efficacy should be promoted, for which new technologies could be helpful.

Declaration of interest

H. De la Corte-Rodríguez has received honoraria for speaking and/or honoraria for consulting, and/or funds for research from Pfizer, Roche, Sobi, NovoNordisk, Takeda and Bayer.

E. C. Rodríguez-Merchán has received honoraria for speaking and/or honoraria for consulting, and/or funds for research from Pfizer, Roche, Sobi, NovoNordisk, Takeda and Bayer.

M. T. Alvarez-Román has received honoraria for speaking and/or honoraria for consulting, and/or funds for research from Takeda, Bayer, CSL-BehringGrifols, Novo Nordisk, Sobi, Octapharma, Roche, Amgen, Novartis and Pfizer.

V. Jiménez-Yuste has received reimbursement for attending symposia/congresses and/or honoraria for speaking and/or honoraria for consulting, and/or funds for research from Takeda, Bayer, CSL-Behring, Grifols, Novo Nordisk, Sobi, Octapharma and Pfizer.

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosure

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.