Paula Loughnane 20/06/2015
Exercise and Sport in
Haemophilia
Paula LoughnaneClinical Specialist Physiotherapist
OLCHC
P. Loughnane 20/06/2015
Content
Benefits of Exercise
Physical Activity patterns
Physical Activity Recommendations: How much exercise? What type of activities?
Preparation for Sport
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Benefits of
Exercise
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• Musculoskeletal benefits
• Muscle strength• Joint stability• Co-ordination• Balance • Flexibility Muscle tone Improved posture Bone density
Mental health benefits↓ stress↓ depression & anxiety↑ self-esteem & self-confidence↑ Perception of social acceptance↑ feelings of well-being
Development of personal skillsDevelop social skillsCooperation, teamwork and leadershipAcademic performance Time Management skillsSelf-organisingPrioritisation skills
Cardiovascular benefits↓ blood pressure ↑ heart muscle contractility ↓ Lowers cholesterol
Disease preventionHeart DiseaseStrokeDiabetesObesityOsteoporosisColon CancerDepression
Blood sugar regulationDecreased fat deposition
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Cycling PE Swimming0
102030405060708090
100
Physical activity in Dutch children and adolescents with Haemophilia
Groen WG et al 2011
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Physical Activity in Irish adults with Haemophilia
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Barriers to physical activity
Fear of injury
Pain
Deconditioning
Inhibitors
Douma-van Riet et al 2009; Mulder et al 2004
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Physical Activity Recommendations
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How much physical activity?
At least
60 minutes daily
World Health Organisation 2010
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What type of activity?
Moderate- to vigorous intensity
High impact activity at least 3 times per week
World Health Organisation 2010
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How to achieve guidelines
Limit sedentary activity
Cut screen time
Encourage physical activity
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Screen time
RecommendationsUnder 2 years: No screen time2-5 years: Less than 1 hour per day5 years and over: Less than 2 hours per day
Australian Government Department of Health. Australia’s Physical Activity and Sedentary Behaviour Guidelines
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Physical Activity across all ages!
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Preparation for Sport
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Preparation for sport
Sport selection
Protective equipment
Prophylaxis
Stretching & warm up
Injury management
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Preparation for sport
Sport selectionProtective equipment
Prophylaxis
Stretching & warm up
Injury management
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Sport Risk categories
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Preparation for sport
Sport selection
Protective equipmentProphylaxis
Stretching & warm up
Injury management
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Protective Equipment
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Preparation for sport
Sport selection
Protective equipment
ProphylaxisStretching & warm up
Injury management
P. Loughnane 20/06/2015
Preparation for sport
Sport selection
Protective equipment
Prophylaxis
Stretching & warm upInjury management
P. Loughnane 20/06/2015
P. Loughnane 20/06/2015
Preparation for sport
Sport selection
Protective equipment
Prophylaxis
Stretching & warm up
Injury management
P. Loughnane 20/06/2015
P. Loughnane 20/06/2015
Lead by example
Active Play
Family time Fun
Start young
Sport:
Preparation is key!
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References• Negrier C, Seuser A, Forsyth A, Lobet S, Llinas A, Rosas M, Heijnen L. “The benefits of exercise for patients with haemophilia and
recommendations for safe and effective physical activity” Haemophilia. 2013 Jul;19(4):487-98. doi: 10.1111/hae.12118. Epub 2013 Mar 28.
• Souza JC, Simoes HG, Campbell CS, Pontes FL, Boullosa DA, Prestes J. “Haemophilia and exercise” Int J Sports Med. 2012 Feb;33(2):83-8. doi: 10.1055/s-0031-1286292. Epub 2011 Nov 17.
• van der Net J, Vos RC, Engelbert RH, van den Berg MH, Helders PJ, Takken T. “Physical fitness, functional ability and quality of life in children with severe haemophilia: a pilot study” Haemophilia. 2006 Sep;12(5):494-9.
• Groen WG1, Takken T, van der Net J, Helders PJ, Fischer K. “Habitual physical activity in Dutch children and adolescents with haemophilia” Haemophilia. 2011 Sep;17(5):e906-12. doi: 10.1111/j.1365-2516.2011.02555.x. Epub 2011 May 4.
• Mulder K, Cassis F, Seuser DR, Narayan P, Dalzell R, Poulsen W. “Risks and benefits of sports and fitness activities for people with haemophilia” Haemophilia. 2004 Oct;10 Suppl 4:161-3.
• Douma-van Riet DC, Engelbert RH, van Genderen FR, Ter Horst-De Ronde MT, de Goede-Bolder A, Hartman A. “Physical fitness in children with haemophilia and the effect of overweight” Haemophilia. 2009 Mar;15(2):519-27.
• von Mackensen S “Quality of life and sports activities in patients with haemophilia” Haemophilia. 2007 Sep;13 Suppl 2:38-43.• Broderick CR, Herbert RD, Latimer J, Barnes C, Curtin JA, Mathieu E, Monagle P, Brown SA. “Association between physical activity
and risk of bleeding in children with hemophilia” JAMA. 2012 Oct 10;308(14):1452-9. doi: 10.1001/jama.2012.12727.• Sherlock E, O'Donnell JS, White B, Blake C. “Physical activity levels and participation in sport in Irish people with haemophilia”
Haemophilia. 2010 Jan;16(1):e202-9. doi: 10.1111/j.1365-2516.2009.02111.x. Epub 2009 Oct 29.• National Hemophilia Foundation. Playing It Safe: Bleeding Disorders, Sports and Exercise. New York: National Hemophilia
Foundation, 2005.• Barnes C, Wong P, Egan B, et al. Reduced bone density among children with severe hemophilia. Pediatrics 2004;114:e177-81.• Koch B, Galioto FM Jr, Kelleher J, Goldstein D. Physical fitness in children with hemophilia. Arch Phys Med Rehabil 1984;65:324-6.• Khair K, Littley A, Will A, von Mackensen S. The impact of sport on children with haemophilia. Haemophilia. 2012 Nov;18(6):898-905. doi:
10.1111/j.1365-2516.2012.02857.x.Epub 2012 May 28.• WHO 2010 Global recommendations on physical activity for health.
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