Exercise and Sport in Haemophilia Paula Loughnane Clinical Specialist Physiotherapist OLCHC Paula Loughnane 20/06/2015.

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

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Preparation for sport

Sport selection

Protective equipment

Prophylaxis

Stretching & warm upInjury management

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Preparation for sport

Sport selection

Protective equipment

Prophylaxis

Stretching & warm up

Injury management

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Lead by example

Active Play

Family time Fun

Start young

Sport:

Preparation is key!

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recommendations for safe and effective physical activity” Haemophilia. 2013 Jul;19(4):487-98. doi: 10.1111/hae.12118. Epub 2013 Mar 28.

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• 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.