Exercise Programmes for People With Haemophilia: A Scoping Review

BACKGROUND: Advances in haemophilia treatment have enabled safe exercise practice as recommended by disease management guidelines, yet there is no gold-standard protocol for optimal dose. Emerging therapies could influence exercise recommendations, highlighting the need for evidence-based guidelines tailored to people with haemophilia to ensure better safety and health outcomes. AIMS: To provide an updated comprehensive mapping of the literature, exploring the modalities, frequency, duration and intensity of exercise programmes for PwH. METHODS: A scoping review was conducted following JBI methodology and PRISMA-ScR guidelines (PubMed, BVS, Scopus, Web of Science, EMBASE, Cochrane, PEDro, SPORTDiscus and grey literature). Inclusion criteria were defined using 'PCC' (population, concept and context), and the research question was 'What modalities, duration, frequency and intensity are being utilised in exercise programmes for PwH in any context?' RESULTS: Out of 5.579 references, 36 studies were included, with 15 reported in a single source. Exercise frequency was mainly set at 3 days/week in primary studies, with a median of 2-4 days/week reported in systematic reviews. Training intensity was mainly defined by repetition maximum or maximum heart rate. Interventions generally lasted 6 weeks, with a median duration of 4-30 weeks in systematic reviews. Strengthening, flexibility, and aerobic exercise were the most common modalities, whereas endurance and proprioceptive training were rarely employed. CONCLUSIONS: Exercise dosages in this review align with current evidence for people with haemophilia, but individualised prescriptions remain critical to optimising health outcomes. Future research should prioritise standardised, evidence-based protocols.