Study Suggests Walking 10K Steps Daily Improves QOL in Severe Hemophilia

A year of follow-up from a study of patients with hemophilia (PWH) suggests that regularly walking can help improve quality of life (QOL) for those with severe forms of the disorder. Among a small group of patients with severe hemophilia, researchers found that patients tracking more than 10,000 steps a day showed significant improvements in their perceived physical health.

The observational study, published in Haemophilia, comes amid a shift in attitudes toward the impact of physical activity among patients with the disorder.

“In past decades, the literature has highlighted that [physical activity] is associated with an increased risk of haemorrhage. However, recent studies have shown that the intensity of PA provides the greatest health benefits and is not associated with the risk of bleeding,” wrote the researchers. “In fact, PA may actually improve the efficacy of treatment and prevention of bleeding in PWH. Therefore, offering prophylaxis to PWH and increasing their understanding of the benefits is essential. In addition, the self-monitoring of exercise at home is helpful for PWH to improve exercise adherence and self-efficacy.”

The researchers prospectively analyzed exercise patterns from 27 patients with severe hemophilia; their mean (SD) age was 36 (9.36) years. On average, patients walked a little over 10,000 steps per day, as tracked by a FitBit, with 63% of participants hitting the threshold each day a year after the study began. This marked an increase from 59% at the start of the study.

Regular walking was shown to significantly improve quality of life and perceived physical health in this analysis of patients with severe hemophilia | Image Credit: KasparsGrinvalds - stock.adobe.com

Just 1 of the 27 patients included in the study reported bleeding from the increased steps they were taking. The patient reported the bleeding event a day following their last FVIII administration.

Hitting the 10,000-step goal was associated with significant improvements in physical health-related QOL, as measured by the physical health subscale of the self-reported questionnaire A36 Hemophilia-QoL. The researchers observed a mean difference of 2.15 (95% CI, 0.64-3.65; P = .007) points among the 32-point subscale.

Although patients maintained their levels of joint health, muscle function, and strength, the group observed no significant differences in Haemophilia Joint Health score, Timed Up and Go test, and muscle strength test. P values for these subscales ranged from .10 to .53. The researchers noted that the absence of functional outcome improvements suggests that the level of physical activity is not enough to help patients improve function, which may require concurrent rehabilitation and exercise programs tailored to each patient.

“The musculoskeletal and biomechanical changes associated with multiple lower limb arthropathies may have a significant impact on a person’s gait efficiency and functional capacity,” explained the researchers. “For example, reduced joint range of motion and increased muscle coactivation may increase the metabolic energy expended during gait, making locomotion less efficient. In addition, these changes often lead to sedentary behaviour, which may lead to further reductions in functional capacity and exercise tolerance. Additionally, a lack of regular exercise can increase the risk of preventable health problems such as obesity and cardiometabolic disease, both in the general population and in PWH.”

The researchers noted that, even when taking into account overestimation of steps from the FitBit, the step count seen in their study is higher than that observed in previous studies. One previous study showed an average of 5800 steps per day among 16 patients with the condition. The group highlighted key differences in patients included in both studies, including that 40.7% of their group was physically active at study initiation while patients in the previous study had a high prevalence of comorbidities, including hepatitis C and HIV.

Reference

Pérez-Alenda S, Carrasco J, Querol-Fuentes F, et al. Benefits of physical activity self-monitoring in patients with haemophilia: a prospective study with one-year follow-up. Haemophilia. Published online March 12, 2024. doi:10.1111/hae.14988