Balance, falls, and exercise: Beliefs and experiences in people with hemophilia: A qualitative study

ESSENTIALS: Exploring exercise beliefs in people with hemophilia may improve efforts at fall prevention. Semi‐structured interviews of adults with hemophilia. Subjects expressed concerns regarding balance, falling, pain, and risks and benefits of exercise. Individualized treatment based on patient beliefs may facilitate exercise and fall prevention. BACKGROUND: Prior research has established that falls are commonplace in adults with hemophilia, and advises that physical therapy and exercise are successful in fall prevention. Recognizing obstacles and catalysts to physical therapy and exercise in people with hemophilia may augment the efficacy of efforts to prevent falls in this population. OBJECTIVES: To learn about the experiences and ideas of patients with hemophilia, especially associated with balance, falls, and exercise. METHODS: Semi‐structured interviews with 14 adult patients with hemophilia were performed. The interviews were coded for themes founded on the study aims. RESULTS: Most subjects described difficulty with balance, often ascribed to joint problems. They believed that staying strong and fit could positively influence balance, but expressed concerns and fear related to falling. Those who exercised regularly did not view exercise as hazardous, while those who did not dependably exercise articulated worry that dangers of exercise may offset the benefits. The most common obstacle to exercise was pain and having someone to exercise with was often described as an enabler. Barriers to partaking in physical therapy included weak proof of its success and distrust in the therapist. Positive physical therapy experiences in the past and the connection with the therapist were reported as facilitators. CONCLUSIONS: People with hemophilia describe some attitudes and experiences that are unique to hemophilia while others are found in the general population. Attending to fear, pain, and support for interventions, while encouraging a robust therapeutic alliance and a plan for routine exercise may aid fall prevention behaviors.