COVID-19 lockdowns reduced physical activity for many people, which presents risks to patients with hemophilia. People with hemophilia experienced a reduced musculoskeletal status during the lockdown period, concludes research published in Healthcare.

The observational study assessed the knee, ankle and elbow joints of 27 people with hemophilia in Spain. A total of 70.4% of people included received prophylactic treatment. The median age of included patients was 42 years and 70.4% had severe disease. There were 25.9% of patients who had moderate disease. 

After lockdown, which lasted from March 14 to June 21, 2020, range of motion decreased in knees, ankles, and elbows (P <.001). Pain intensity increased (P <.001) and pain threshold dropped in all joints. The mean weight of patients included increased during the lockdown from 80.50 kg to 82.50 kg (P <.001).

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Patients had a higher frequency of hemarthrosis in the elbows (P <.04), but a reduced incidence of bleeding in the ankles (P <.01), and no change in knee joints. The authors speculated the reduction in ankle bleeding could be because of reduced walking and more sedentary lifestyles during lockdown.

The authors noted that the study is limited by the lack of measures of psychosocial variables and lack of joint functionality assessment.

The outcomes of this study could be used to establish the effects of quarantine periods on patients with hemophilia and to develop strategies to reduce negative effects. Remote physiotherapy, educational programs, and other non-face-to-face interventions may help maintain physical activity of patients and help reduce joint health deterioration.


Cuesta-Barriuso R, Meroño-Gallut J, Pérez-Llanes R, Ucero-Lozano R. Musculoskeletal changes in hemophilia patients subsequent to COVID-19 lockdown. Healthcare (Basel). 2021;9(6):702. doi:10.3390/healthcare9060702