Moving beyond limitations: A narrative review exploring the intersection of haemophilia and physical activity
Bibliographic record
Abstract
Abstract Persons with haemophilia (PwH) have historically been advised to avoid physical activity (PA) to limit bleeding risk, leading many to adopt sedentary lifestyles. The paradigm shift in treatment for PwH toward prophylaxis with extended half-life factor concentrates and non-factor replacement therapy has substantially reduced joint bleeding and deterioration, allowing PwH to lead more active lives with improved protection against bleeds. This has led to increased recognition of the importance of regular PA for musculoskeletal strength, joint and cardiovascular health, quality of life, and social/psychological well-being among PwH. Nonetheless, hesitation regarding risks of PA for PwH persists, and key clinical questions including haemostatic protection for safe participation in PA remain largely unanswered. This narrative review summarises the considerations for PA in PwH and its role in haemophilia management with associated recommendations from key organisations, focusing on shared decision-making and individualised treatment planning. Key strategies to increase PA among PwH include promoting sustained behavioural change and potential use of wearable activity trackers. Higher haemostatic potential is consistently associated with protection against PA-related bleeds. An increasing evidence base indicates that both factor and non-factor therapies can safely enhance physical function and support greater PA, although additional evidence is needed for novel and emerging treatments. Further research is needed to help clinicians individualise prophylaxis regimens in a holistic manner that includes consideration of PA. Recommendations for PA in PwH must continue to progress alongside the evolving therapeutic landscape.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.032 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.004 | 0.005 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".