Subjective Physical Performance and Its Determinants in Patients With Haemophilia

Introduction

Physical functioning is compromised in patients with haemophilia (PwH). However, factors negatively influencing subjective physical performance (SPP) remain underexplored. Hence, this study aimed to compare the SPP of PwH with healthy controls (CON), to differentiate them based on disease-specific, person-related, and arthropathy-related parameters, and to identify overarching determinants influencing SPP.

Methods

SPP was assessed in 301 PwH and 263 CON via the HEP-Test-Q, which divides SPP into a total score and four distinct dimensions (e.g., mobility). Additionally, disease-specific (i.e., type, severity, treatment regime, HIV, hepatitis), person-related (i.e., age, BMI), and arthropathy-related parameters (i.e., current pain intensity (NRS-now) and average pain intensity across 4 weeks (NRS-4w) and the HJHS) were examined, and associations with SPP were calculated.

Results

All PwH and PwH subgroups demonstrated significantly greater impairment across all SPP dimensions compared to CON. Apart from the type of haemophilia (A vs. B, p = 0.894), significant differences in total SPP were observed among PwH subgroups for severity (severe vs. non-severe, p = 0.012), treatment (prophylaxis vs. on demand, p = 0.002), HIV (no vs. yes), and hepatitis (no vs. yes, both p < 0.001). A multiple linear regression model further revealed significant predictive effects for HJHS (p < 0.001) and NRS-4w (p < 0.001) on the total SPP score.

Conclusion

PwH perceived their physical performance as significantly worse across all dimensions compared to CON. The decreased SPP in PwH can be attributed primarily to arthropathy-related factors, that is, an impaired joint status and persistent pain. To oppose the decline in SPP, tailored sports-therapeutic programs should be integrated into the multimodal treatment concept.