Table 1: Details of the studies included in the review (min: minutes).

Gurcay et al. (2008) [10]Hilberg et al. (2003) [11] Garcia et al. (2009) [12]Hill et al. (2010) [13]Czepa et al. (2013) [14]

Type of studyPretest-posttest studyPretest-postest study with control group being not homogeneusPretest-postest study with control group being not homogeneusPretest-postest studyPretest-postest study with two control groups

Participants31 patients with hemophilia. Mean age: 13.02 y9 patients with hemophilia (experimental group), 8 subjects without hemophilia (active control group, AC), and 11 subjects without hemophilia (passive control group, PC).
Mean age: 34.33 y
9 patients with hemophilia and arthropathy (experimental group) and 9 patients with no pathology or articular anomaly.
Mean age: 9 y
20 patients with hemophilia.
Mean age: 39.4 y
13 patients with hemophilia (active PwH), 12 patients with hemophilia (passive PwH), and 19 subjects without hemophilia (controls)

Experimental versus control intervention (no. of participants)Isometric, isotonic, strengthening, and proprioception exercise ( )Strength and propioception training ( ); strength and propioception training—active control group—( ); versus care as usual ( )Vertical bicycle, ability to control breathing, ability to control the rotations, and activities for balance, buoyancy, and immobility control ( ); same intervention in control group ( )Balance and lower limb strength exercises and a walking programme ( )Sports therapy with exercise to increase focal points in terms of body awareness, muscle tone regulation, joint mobilization, and muscle activation

Duration4 weeks24 weeks4 weeks16 weeks52 weeks

Frequency5 times/week2 times/week2 times/week5–7 times/week1 time/week (0.98 point in scale 0–4)

Intensity300 minutes/week240 minutes/week60 minutes/weekNo dataNo data

Outcomes of experimental groupSignificant changes in flexion and dorsiflexion ( ) and inversion and eversion ( ) of ankle. Improvement in pain, disability, and clinical assessment ( ).One-leg-stand test: differences between H and PC groups ( ) and H and AC groups ( ). Angle-reproduction test: differences between H and PC groups ( ). Tuning fork test: differences between H and PS groups ( ) and H and AC groups ( )Significant changes in the ROM of left ankle in hemophilia ankle: between sessions ( ) and between all sessions ( ).Significant changes in static balance ( ); dynamic bilateral stance balance ( ); dynamic single limb balance ( ); gait and mobility ( ); activity ( ); and fear of falling ( ). Active PwH reported significant changes in subjective physical performance in the HEP-test-Q domains “strength and coordination,” “endurance,” and “body perception” as well as the total score compared to the other groups.
A longer walking distance for the active PwH compared with controls in the 12 min walk test.

Measuring instrumentsGoniometer (ROM), Jafar-C (functional disability), EVA (pain. score 0–3), and clinical evaluation score (adopted by WFH)One-leg-stand test, Posturomed test, angle reproduction test, and tuning fork test (propioception); strength test (isometric muscular strength)Goniometer (ROM) Functional Reach test, step test, and timed up and go test (clinical measures of balance); mCTSIB test and LOS test (laboratory measures of balance); walking across the long plate test and step and quick turn (gait measures); Human Activity Profile (physical activity); MFES (falls Efficacy); and VAS (pain. score 0–10)Activity level (scale 0–4), goniometer (ROM), one-leg-stand test, and 12 min walk test

Pharmacology CointerventionProphylaxis treatment (2-3 times/week)Prophylaxis treatment (if necessary)No dataNo dataPatients were on prophylaxis or on demand treatment, according to medical criteria

Adverse effects2 patients developed hemarthrosis during treatmentNo patient developed hemarthrosis during treatmentNo dataNo patient developed hemarthrosis during treatment.No patient developed haemarthrosis during treatment.