Exploring risk factors for reduced physical activity and functional abilities in adults with hemophilia: a cross-sectional survey from a single large hemophilia treatment center Open Access

Abstract

Physical activity and functional abilities are important to maintaining quality of life in the aging hemophilia population. The risk factors leading to reduced physical activity and functional limitations in people with hemophilia are under-explored. Physical activity and functioning were evaluated in persons with hemophilia at a single large hemophilia treatment center to determine the risk factors for reduced physical activity and functional limitations, and specifically to examine the relationship between joint disease (arthropathy) and reduced physical activity/functional limitations. Data were obtained on 88 patients via the medical record, patient questionnaires and clinical examination. The World Federation of Haemophilia (WFH) orthopedic joint score was used as a measure of arthropathy. The Framingham Physical Activities Index (PAI), the Hemophilia Activities List (HAL), and the Timed Up-and-Go Test (TUG) were used as outcome measures. We used multiple linear regression to assess the relationship between our dependent variables and the covariates. The HAL summary score decreased 5.8 points per 10 point increase in WFH score (P=.04), decreased 12.0 points in patients with chronic liver disease (P=.006), and decreased 2.5 points for each target joint (P=.02). PAI score decreased by 5.5% for every ten years of age (P<.0001) and TUG average time increased 5% for every ten years of age (P=.01). The present study provides some evidence for the relationship between arthropathy and reduced physical functioning. It appears that improving joint health and preventing chronic liver disease could improve functional independence among adults with hemophilia. However, reducing the risk for falls and increasing overall physical activity will require further understanding of factors that influence these important measures of physical functioning and physical activity.

Table of Contents

Contents

Introduction....................................................1

Methods...........................................................2

Subjects.................................................2

Independent Variables.........................2

Dependent Variables............................3

Data Analysis...................................... 4

Results............................................................5

Patient Characteristics........................ 5

Linear Regression Analysis................5

PAI....................................................5

HAL..................................................6

TUG..................................................6

Discussion......................................................6

Summary of Models.............................6

Relationship to Literature....................7

Clinical Significance.............................7

Limitations of the Study......................8

Strengths of the Study........................8

Conclusion.....................................................9

Summary............................................... 9

Future Studies......................................9

References.....................................................9

Tables.............................................................11

Appendix A - Additional Figures............. 15

Appendix B - SAS Code .............................21

About this Master's Thesis

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School	Rollins School of Public Health
Department	Biostatistics and Bioinformatics
Subfield / Discipline	Biostatistics - MPH & MSPH
Degree	MSPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	hemophilia
Committee Chair / Thesis Advisor	Elon, Lisa, Emory University
Committee Members	Kempton, Christine, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs

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