Mobility and physical activity and hemophilia
Are children with hemophilia able to exercise or not? Important symptoms of hemophilia include prolonged nosebleeds, bleeding gums, and large bruises on the skin. What are the effective treatment strategies in this regard? In the following, we will examine the do’s and don’ts of exercise, mobility and physical activity in children with hemophilia.
People with hemophilia often bleed easily. Depending on the severity of the bleeding, the bleeding may occur spontaneously (without any injury or surgery) or after surgery or injury. Symptoms include:
Prolonged bleeding after surgery or injection, for example after circumcision
Swelling of large joints (shoulders, elbows, knees, ankles) caused by bleeding from a joint
Pain due to bleeding in the joints and muscles
How is hemophilia diagnosed?
When a boy or a man bleeds and the bleeding seems to be heavy, it can be a sign of hemophilia. The disease is diagnosed through clotting factors (actually the protein that should clot the blood). Your specialist doctor will order tests called prothrombin time (PT) and relative thromboplastin time (PTT) to assess the whole body coagulation system. In hemophilia, PTT is longer.
If the PTT is long (ie higher than normal), the lack of coagulation factor will be the cause. At this point, your doctor will prescribe clotting factors 8, 9, and 11 (actually a protein in the blood that prevents bleeding). These three factors are measured simultaneously; Unless there is a family history of such an issue. This allows the doctor to identify the percentage of activity of any of the factors that are low in hemophilia.
Types of hemophilia
Hemophilia can be classified according to the absence of coagulation factor:
1. Hemophilia A, which is caused by a deficiency of factor 8.
2. Hemophilia B (also known as Christmas disease) is caused by a deficiency of factor 9.
3. Hemophilia C (also known as Rosenthal syndrome) is caused by a deficiency of factor 11.
Hemophilia can also be classified according to the amount of clotting factor in the blood. The lower your clotting factor, the more bleeding you will have.
Mild: 6 to 40%
– Average: 1 to 5 percent
Intensified: less than 1%
How can hemophilia be treated?
Hemophilia can be treated by concentrating the relevant agents. This concentration of agents is injected into a vein. Hemophilia is usually treated in two ways: as needed (when diarrhea occurs) or as a follow-up (once, twice or three times a week to receive the relevant agent to prevent bleeding). How you are treated is determined by a number of factors, including the severity of the bleeding mentioned earlier. Fortunately, most hemophilia treatments can be done at home. In fact, parents can learn how to inject the agent into a child’s vein, or a babysitter can do the same.
Although factor concentration is the preferred method of treating hemophilia, it is not available in all countries. Hemophilia can also be treated with blood products. For example, factor 8 deficiency can also be treated with cryoprecipitate (a concentrated form of plasma). Freshly frozen plasma can be used to treat factor 8 and factor 9 deficiency.
Can my child with hemophilia exercise?
Knowing that your son (or, in rare cases, your daughter) has hemophilia (or another bleeding disorder) can lead to life changes, especially if the family has no family history. Many questions may occupy your mind in this regard. One of the most common questions heard in pediatric hemophilia clinics is, “Can my child still exercise?” The short answer to this question is “yes”, but there are other things to consider.
Although spontaneous bleeding is very common in cases of acute hemophilia, bleeding is associated with injuries resulting from various types of hemophilia.
When it comes to exercising children with hemophilia, this is one of the biggest concerns, especially in sports that have more contact (such as basketball) or a lot of collisions (such as soccer). Although there are concerns about certain exercises, experts recommend that all patients with hemophilia should be physically active. This includes attending physical activity classes at school, with specific restrictions. Being in good physical condition will prevent injury or bleeding. However, the risks and benefits of any physical activity must be carefully considered.
There are many factors that determine whether your child can exercise or not, or what sports are safe for your child. These factors include the following:
Severe hemophilia of your child: Patients who have been more severely affected by the disease are more likely to bleed after a sports injury. Families of children with severe hemophilia should try to identify the bleeding immediately after the sports injury and treat it immediately. Families of children whose hemophilia is much milder should always be vigilant and aware of this issue and start treatment as soon as possible.
Frequency of joint bleeding or related disease: Bleeding from the joints will often be associated with damage to the joints themselves, which increases the risk of further bleeding. The point to keep in mind is to be able to determine which joints are more likely to be injured during exercise. So if there is a possibility of injury to his elbows, tennis may not be a good option for him.
-Level of activity: As the child gets older, the intensity of the exercise also increases. For teens, basketball is a relatively safe sport, but if your child is on a school team, this will need to be re-evaluated as the risk of injury increases.
Recent bleeding: The important thing after bleeding is to talk to your child’s hemophilia treatment team to see if exercising is safe for him or her. Increased physical activity after a short time and very soon after such events can lead to re-bleeding or joint damage.
The National Hemophilia Association classifies them into three groups based on the risk of each sport or physical activity. This classification is also commonly used for other bleeding disorders, such as dysfunction of blood platelets. These categories are as follows:
Category 3: Dangerous. These activities and sports are not recommended for hemophilia children at all because they are highly threatening for these people.
BMX cycling on dirt roads
Category 2.5: Medium to dangerous
Category 2: Mild danger
Rowing / rowing
Category 1.5: Mild to moderate risk
Weightlifting (resistance training, not powerlifting)
Category 1: Safe
Elliptical or space ski device
If your child with hemophilia likes to exercise, you should try to let their hemophilia treatment team know so that the right decision can be made. For some sports, minor changes can reduce the risk of bleeding. For example, when playing baseball, it is recommended that your child wear a hat and preferably avoid slipping or tackling on the ground. He should also wear a hat when cycling or skating. For patients with acute hemophilia, one of the potential solutions for high-risk exercise (not, of course, category 3, which is not recommended at all) is to schedule a preventative medication before exercising. Patients with mild to moderate hemophilia need to inject prophylaxis, especially during exercise.
As you know, this disease is an inherited bleeding disorder. A person with hemophilia needs a blood clot to be able to clot the blood, which can lead to heavy bleeding.