Safety and functional benefits of a 6-Month adapted exercise program in adults with haemophilia

Introduction Haemophilia, a genetic disorder caused by a deficiency in clotting factors, often leads to musculoskeletal complications such as arthropathy, which reduces function and can induce kinesiophobia. Regular physical activity, as recommended by the World Federation of Haemophilia, supports musculoskeletal health, coordination, weight control and psychological well-being. This study explores the safety and the changes in functional capacity, strength, and balance following a 6-month adapted exercise program in adults with haemophilia. Methods The study employed a single-arm, within-subjects design with assessments at baseline (T0) and two follow-ups at 3 months (T1) and 6 months (T2); during the period between T0 and T2, participants completed a twice-weekly, individually tailored physical-activity program supervised by qualified specialists. Functional capacity was assessed using the Six-Minute Walk Test (6MWT) with the BTS G-WALK system. Perceived fatigue and dyspnea were recorded after each 6MWT using the Borg and VAS scales, respectively. Secondary outcomes included the 30-second Chair Stand Test (30″CST) to assess lower-limb strength, the Single-Leg Stance Test (SLST) for static balance, and the Timed Up and Go (TUG) test for dynamic balance. Data were analysed using nonparametric tests: the Shapiro–Wilk test assessed normality; Friedman test evaluated repeated measures, with Wilcoxon signed-rank tests and Bonferroni correction for post hoc comparisons (p < 0.05). Results Participants showed significant gains in functional capacity and balance over six months, while mean TUG duration remained stable. Improvements were most marked in 6MWT distance (p<0.001), 30″ CST (p = 0.003) and single-leg stance (both p<0.01), with smaller but significant reductions in fatigue and dyspnea at 6 months. No significant change was observed for mean cadence or TUG time. See Table 1 for full details. No adverse events were recorded during the exercise program period. Discussion This study supports the safety of a 6-month supervised adapted exercise program for adults with haemophilia. Significant improvements were observed in functional capacity, lower-limb strength, and balance, along with reduced perceived fatigue and dyspnea. The absence of adverse events further reinforces the safety of such interventions in this population. Despite the single-arm design and small sample, findings endorse adapted exercise as a safe, effective adjunct in haemophilia care, in line with systematic reviews on resistance and aerobic benefits [1,2]. Further randomized trials are warranted to confirm these benefits and to establish optimal exercise dosing.