PhD Defense: Sports Participation, Injuries and Bleeds in People with Haemophilia

Haemophilia is a congenital condition causing blood to clot more slowly after bleeding. Treatment is possible, unlike curation. People with haemophilia were traditionally discouraged to participate in (contact) sports because of the risk of bleeding. Improved treatment options gave people with haemophilia more opportunities to participate in sports. However, the debate about safe sports for people with haemophilia is ongoing.     

This study shows that people with haemophilia are just as active in sports as people without haemophilia (~60%) and a similar proportion reported sports injuries (~18%). Furthermore, the number of sports-induced bleeds was low (26 in 15,999 exposure moments). Therefore, people with haemophilia do not seem to be at an increased risk for sports injuries or sports-induced bleeds.

People with sports-related bleeds had lower levels of clotting factor in their blood than those who without sports-induced bleeds and administered their clotting factor longer before exercise. As long as clotting factors were at least 10% at the time of exercise, the risk of a sports-induced bleed halved. This seems to confirm the existing advice to take clotting products as shortly as possible before exercise.
                
Ideally, we would like to predict sports injuries and bleeds. For this, risk factors need to be identified. We tried to identify these by administering a number of physical tests, which we tried to associate with sports injuries. Unfortunately, these tests were unable to predict injuries or bleeds.
The association between new long acting concentrates and sports injuries and sports-induced bleeds is an important future research area.