A new study involving surveys of clinicians in Italy suggests that for patients with hemophilia, participation in physical activity is perceived as providing benefits for quality of life, joint stability, and other outcomes. The study’s results were published in the International Journal of Environmental Research and Public Health.

Among the clinicians surveyed in the study based in Puglia, Italy, were 6 hematologists and 15 sports physicians. The clinicians were asked in a 29-question survey about their approaches and suggestions regarding physical activity with patients who have hemophilia.

Hematologists in this study indicated they treated 675 patients per year on average, of whom 7% have hemophilia A or B. Sports physicians indicated seeing 1033 patients per year on average, of whom 0.8% have hemophilia. Patients with hemophilia seen by clinicians in this study had an average of 11 visits with hematologists, and 3 visits with sports physicians, per year. Nearly half of the patients with hemophilia treated by clinicians in this study were above 18 years of age.

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Less than one-third (31%) of patients reportedly asked their hematologists about participation in sports. Additionally, only 16% of patients seen by hematologists for follow-ups ultimately participated in sports. Sports physicians, on the other hand, reported a higher rate (71%) of patients with hemophilia requesting advice regarding sports, and 67% of patients they saw participated in sports.

The sports that sports physicians recommended most for patients with hemophilia were swimming (93%), athletics (33%), tennis (27%), running (27%), and gymnastics (27%). The sports most recommended by hematologists were swimming (67%), cycling (67%), athletics (33%), and football (33%). However, 33% of hematologists and 67% of sports physicians recommended that football be avoided. Most physicians from both groups suggested boxing/fighting should be avoided by patients with hemophilia, with 83% of hematologists and 93% of sports physicians making this recommendation.

Across survey questions, most hematologists indicated that regular physical activity was relevant for improving quality of life, joint stability, reduction of bleeding risk, musculoskeletal well-being, and psychological, emotional, and social well-being in patients with hemophilia. Lower proportions of sports physicians rated regular physical activity as being as relevant for any of these areas of health in patients with hemophilia.

Both groups of clinicians considered the greatest perceived barriers for patients with hemophilia in practicing sports to be patient fears of trauma or bleeding and lack of information about physical activity.

All surveyed hematologists indicated the practice of sports could be promoted for patients with hemophilia complying with appropriate prophylaxis, and 67% recommended that factor be infused prior to activity. Sports physicians did not rate these interventions to be as relevant, but they considered greater access to emergency resources to be valuable.

The study investigators concluded that enhancing the knowledge base among sports physicians regarding hemophilia may help with patient involvement in physical activity. Overall, survey results suggested that improved awareness of guidelines and clinical practice protocols would be useful.

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


Lassandro G, Accettura D, Giordano P. Promoting sports practice in persons with hemophilia: a survey of clinicians’ perspective. Int J Environ Res Public Health. 2021;18(22):11841. doi:10.3390/ijerph182211841