GYM project: physical fitness improves the well-being of young men with hemophilia

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A hemophilia-specific exercise program called Project GYM has been shown to improve psychological well-being and self-confidence in young men with hemophilia between the ages of 18 and 25.1.2

“Many young men with hemophilia are involved in physical activity and sports, but face challenges in participation due to their [condition]wrote Paul McLaughlin, MSc, of the Katharine Dormandy Haemophilia Center and Thrombosis Unit of the Royal Free London NHS Foundation Trust in London, UK, and his co-authors.1

The researchers published the results of 2 studies on the safety and feasibility of the GYM project in Research and practice in thrombosis and hemostasis.1.2


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Unblinded randomized feasibility study

A randomized, unblinded study was conducted to assess the feasibility of the GYM project and its effect on physical activity, motivation and exercise adherence. The researchers included 19 young men with haemophilia A or B (all severities, with or without an inhibitor) from three haemophilia centers in London.

All study participants received an activity tracker and a gym membership, and were randomized into “gym only” or “gym and personal trainer” groups. Questionnaires were administered at baseline and at 6 months to assess participants’ motivation to exercise, physical activity levels, quality of life, self-efficacy and self-esteem.

After analysis, the researchers found that participants in the “gym and personal trainer” group had higher gym attendance compared to the “gym only” group. Specifically, 7 participants increased their activity level, while 9 remained the same, with no statistical difference between the groups.

Median hemophilia joint health scores (HJHS) improved in 3 participants but remained unchanged in 12. Additionally, there was no activity-related bleeding.

Observational feasibility study

Kate Khair MSc, PhD, from the same institution as Dr. McLaughlin, conducted a separate observational study in the same cohort as the randomized study. She and her team used thematic analysis to analyze recorded individual interviews about study participation.

After analysis, they found that there was a significant difference in motivation to exercise, as shown by grouping the stages of change from contemplation to action and maintenance phases (P =.03). Additionally, global self-efficacy scores tended to improve, but were not statistically significant (P <.06>

Additionally, participants’ median self-esteem scores increased from 22 (range 12 to 30) to 25 (range 13 to 30) and were significant (P =.02).

“Key themes identified in the interviews were: fear, self-confidence, ‘being normal’, pain, weight loss, ability, and fitness,” Dr. Khair and coauthors wrote.

“The psychological well-being of young men with hemophilia improved during this study, [which] may have been linked to participation in a gym exercise program,” they added.

Future directions

Importantly, this was the first study to evaluate a non-medical gym environment and a personal trainer-led fitness program in people with hemophilia. Overall, results from both studies showed that training with personal trainers resulted in greater gym attendance and participants felt more supported compared to the “gym-only” intervention. “.

“[We] emphasize the need to [better] understand support needs in future studies,” the researchers concluded. “Behavior change theory and techniques should be included when studying gym activities for young men with hemophilia.”

“Going forward, we would like to replicate this study, especially in women, and we are currently seeking additional funding to continue the project,” Dr. Khair said in an email interview.

Disclosure: Some guideline authors have claimed to be affiliated with or have received funding from the pharmaceutical industry. Please refer to the original study for a full list of disclosures.

References

  1. McLaughlin P, Holland M, Dodgson S, Khair K. GYM Project: A Randomized Feasibility Study Investigating the Motivational Effect of Personal Trainer-Led Exercise in Young Men with Hemophilia. Res Pract Thromb Haemost. 2021;5(8):e12613. doi:10.1002/rth2.12613
  2. Khair K, Holland M, Dodgson S, McLaughlin P, Fletcher S, Christie D. Physical fitness improves psychosocial well-being and self-confidence in young men with hemophilia: results from the GYM project. Res Pract Thromb Haemost. 2021;5(8):e12622. doi:10.1002/rth2.12622

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