From the Journals

Combined exercise training shows benefit in hemophilia A



Combined aerobic and resistance exercise training was found to be the most effective training technique to reduce proinflammatory markers in overweight patients with moderate hemophilia A.

“Combined training has been established as the most effective type of exercise in terms of modification of cardiovascular disease risk factors,” wrote Behrouz Parhampour, of Iran University of Medical Sciences in Tehran, and colleagues. The findings of the study were published in Haemophilia.

The researchers conducted a randomized clinical study of 48 patients with moderate hemophilia A. Study patients had a body mass index of 25-30 kg/m2 and were aged 35-55 years.

Study participants were randomly allocated to aerobic training (n = 12), resistance training (n = 12), combined training (n = 12), and control (n = 12) arms. The training regimens consisted of 45‐minute sessions three times per week for a total of 6 weeks.

Interleukin‐10, adiponectin, tumor necrosis factor–alpha, IL‐6, and high-sensitive C‐reactive protein were measured before and after training. Weight-related measures, including waist‐to‐hip ratio and waist circumference, were also evaluated.

The researchers found there was a significant reduction in weight, waist‐to‐hip ratio, waist circumference, and body mass index in the combined, resistance, and aerobic training arms, compared with the control arm.

Additionally, they reported a significant reduction in high-sensitive C‐reactive protein, IL‐6, and tumor necrosis factor–alpha levels in the combined training group versus the control group (P equal to or less than .02 for all three).

There were no episodes of bleeding among patients in any of the intervention groups.

“The possible mechanism for the effect of exercise training on weight loss is to increase metabolic consumption which may subsequently reduce the low‐grade inflammation commonly noted among overweight patients,” the researchers wrote.

The authors acknowledged that two key limitations of the study were the short duration of training and small sample size.

“Combined training can be used as an effective nonpharmacological strategy to improve joint function and prevent disorders associated with sedentary lifestyle like cardiovascular complications in [hemophilia patients],” they concluded.

The study was funded by the Iran University of Medical Sciences. The authors reported having no conflicts of interest.

SOURCE: Parhampour B et al. Haemophilia. 2019 May 26. doi: 10.1111/hae.13764.

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