A hemophilia-specific fitness training program, termed Project GYM, was shown to improve psychological wellbeing and self-confidence in young men with hemophilia aged 18 to 25 years.1,2

“Many young men with hemophilia engage in physical activity and sport, but face challenges to participation because of their [condition],” wrote Paul McLaughlin, MSc, of the Katharine Dormandy Haemophilia Centre and Thrombosis Unit at the Royal Free London NHS Foundation Trust in London, UK, and his coauthors.1

The researchers published the results of 2 studies on the safety and feasibility of Project GYM in Research and Practice in Thrombosis and Haemostasis.1,2


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Nonblinded, Randomized Feasibility Study

A nonblinded, randomized study was conducted to evaluate the feasibility of Project GYM, and its effect on gym activity, motivation, and adherence to exercise. The researchers included 19 young men with hemophilia A or B (all severities, with or without inhibitor) from 3 hemophilia centers in London.

All study participants were provided an activity tracker and gym membership, and were randomized to “gym only” or “gym and personal trainer” groups. Questionnaires were administered at baseline and 6-months to evaluate participants’ motivation to exercise, physical activity levels, quality of life, self-efficacy, and self-esteem.

After analysis, the researchers found that participants within the “gym and personal trainer” group had greater gym attendance compared with the “gym-only” group. Specifically, 7 participants increased their activity levels, while 9 remained the same, with no statistical difference between the groups.

The median Hemophilia Joint Health Scores (HJHS) improved in 3 participants, but were unchanged in 12. Moreover, there was no bleeding related to gym activity.

Observational Feasibility Study

Kate Khair MSc, PhD, of the same institution as Mr McLaughlin, led a separate observational study in the same cohort as the randomized study. She and her team used thematic analysis to analyze individual audio-recorded interviews about study participation.

After analysis, they found that there was a significant difference in motivation to exercise as shown by the Stages of Change grouping moving from contemplation to action and maintenance phases (P =.03). In addition, self-efficacy overall scores trended towards improvement, but were not statistically significant (P <.06).

Furthermore, the median self-esteem scores of participants improved from 22 (range 12-30) to 25 (range 13-30), and were significant (P =.02).

“Key themes identified from the interviews were: fear, self-confidence, “being normal,” pain, weight loss, ability, and getting fitter,” Dr. Khair and coauthors wrote.

“The psychological wellbeing of young men with hemophilia improved during this study, [which] may have been related to participating in a gym-based, physical exercise program,” they added.

Future Directions

Importantly, this was the first study to evaluate a nonmedical gym environment and personal trainer-led physical fitness program in people with hemophilia. Overall, the results from both studies showed that training with personal trainers led to greater gym attendance and participants felt more supported compared with “gym-only” intervention.

“[We] highlight the need to [better] understand support needs in future studies,” the researchers concluded. “Behavior change theory and techniques should be included when investigating gym-based activity for young men with hemophilia.”

“In the future, we would love to replicate this study, particularly in women, and we are currently seeking additional funding to continue the project,” Dr. Khair said in an email interview.

Disclosure: Some guideline authors have declared affiliations with or received funding from the pharmaceutical industry. Please refer to the original study for a full list of disclosures.

References

  1. McLaughlin P, Holland M, Dodgson S, Khair K. Project GYM: a randomized feasibility study investigating effect on motivation of personal trainer-led exercise in young men with hemophilia. Res Pract Thromb Haemost. 2021;5(8):e12613. doi: 10.1002/rth2.12613
  2. Khair K, Holland M, Dodgson S, McLaughlin P, Fletcher S, Christie D. Fitness enhances psychosocial well-being and self-confidence in young men with hemophilia: results from Project GYM. Res Pract Thromb Haemost. 2021;5(8):e12622. doi: 10.1002/rth2.12622