Exercise Guidelines for People with Haemophilia: Insights from a Scoping Review

Designing safe and effective haemophilia exercise programs is now more achievable thanks to significant advances in clotting factor therapies. Clinicians can encourage patients to engage in regular physical activity to improve joint health and muscle strength. Furthermore, a recent scoping review provides a comprehensive mapping of the literature regarding optimal exercise dosages. Consequently, the findings suggest that structured physical activity can significantly enhance the quality of life for those living with bleeding disorders.

However, experts emphasize that there is still no single gold-standard protocol for every patient. In addition, individualization remains a critical factor in ensuring patient safety and preventing spontaneous joint bleeds. Establishing a baseline of physical capacity requires a careful assessment of the patient's current joint health and prophylaxis status.

Key Components of Haemophilia Exercise Programs

The review mapped data from 36 studies to determine the most effective modalities and frequencies. Researchers found that most primary studies recommend an exercise frequency of three days per week. Moreover, strengthening, flexibility, and aerobic exercises are the most common modalities used in successful interventions. Therefore, clinicians should prioritize these activities while gradually introducing more complex movements.

Training intensity in these haemophilia exercise programs is typically defined by repetition maximum or maximum heart rate. While interventions generally last for six weeks, some systematic reviews report longer durations of up to 30 weeks. Interestingly, endurance and proprioceptive training remain rarely employed, despite their potential benefits for long-term joint stability. Because these areas are under-researched, future protocols should aim to integrate balanced training regimens.

Optimizing Long-term Health Outcomes

The transition toward evidence-based exercise prescriptions represents a major step forward in haemophilia management. By following standardized protocols, healthcare providers can help patients achieve better health outcomes while minimizing risks. Ultimately, regular monitoring and tailored adjustments will ensure that each patient receives the maximum benefit from their physical activity routine.

Frequently Asked Questions

How often should people with haemophilia exercise?

Most clinical evidence suggests a frequency of three days per week to optimize muscle strength without overstressing the joints.

What are the safest types of exercise for haemophilia?

Strengthening, flexibility, and aerobic exercises are widely considered the safest and most effective modalities for improving physical function in this population.

How is exercise intensity measured in these programs?

Clinicians often use repetition maximum (RM) or maximum heart rate (HRM) to define and monitor the intensity of physical activities safely.

Disclaimer: This content is for informational and educational purposes only. It does not constitute professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Refer to the latest local and national guidelines for clinical practice.

References

Veríssimo M et al. Exercise Programmes for People With Haemophilia: A Scoping Review. Haemophilia. 2026 Feb 20. doi: 10.1111/hae.70225. PMID: 41719054.

Srivastava A, Santagostino E, Dougall A, et al. WFH Guidelines for the Management of Hemophilia, 3rd edition. Haemophilia. 2020;26(Suppl 6):1-158. doi: 10.1111/hae.14046.

Biasoli C, Baldacci E, Coppola A, et al. Promoting physical activity in people with haemophilia: the MEMO (Movement for persons with haEMOphilia) expert consensus project. Blood Transfus. 2022;20(1):66-77. doi: 10.2450/2021.0138-20.