Abstract：
BACKGROUND: Although resistance training is frequently prescribed for people with haemophilia (PWH), no previous meta-analyses have quantified the effect of this intervention on muscle strength, nor the implications of the intervention\'s modality and duration.
OBJECTIVE: (1) To determine the effects of resistance training on muscle strength in adults with haemophilia; (2) To determine the most effective duration and modality among the exercise protocols.
METHODS: A systematic search from inception until 28 November 2023 was conducted in PubMed, Embase, Web of Science, CENTRAL and CINAHL databases. We included randomised controlled trials or before-after studies that involved resistance training without other physiotherapy co-interventions. Study selection, data extraction and risk of bias assessment were independently performed by two reviewers. Disagreements were resolved in consultation with a third author. The level of evidence was determined according to the GRADE methodology.
RESULTS: Seven studies were included. Measurements of knee extensor strength and elbow extensor strength were included in the meta-analysis. Subgroup analysis showed significant effects for both elastic resistance protocols (SMD: 0.54; 95% CI: 0.02-1.07) and conventional training (isometric and weight-based equipment) (SMD: 0.88; 95% CI: 0.50-1.25), demonstrating small and moderate effect sizes respectively. Additionally, both protocols of duration 5-7 weeks (SMD: 1.16, 95% CI: 0.63-1.69) as well as those of duration ≥8 weeks (SMD: 0.57, 95% CI: 0.20-0.94) showed a significant difference.
CONCLUSIONS: Resistance training is effective in improving muscle strength of the knee and elbow extensors in PWH. Both elastic resistance and conventional training show benefits.
OBJECTIVE: (1) To determine the effects of resistance training on muscle strength in adults with haemophilia; (2) To determine the most effective duration and modality among the exercise protocols.
METHODS: A systematic search from inception until 28 November 2023 was conducted in PubMed, Embase, Web of Science, CENTRAL and CINAHL databases. We included randomised controlled trials or before-after studies that involved resistance training without other physiotherapy co-interventions. Study selection, data extraction and risk of bias assessment were independently performed by two reviewers. Disagreements were resolved in consultation with a third author. The level of evidence was determined according to the GRADE methodology.
RESULTS: Seven studies were included. Measurements of knee extensor strength and elbow extensor strength were included in the meta-analysis. Subgroup analysis showed significant effects for both elastic resistance protocols (SMD: 0.54; 95% CI: 0.02-1.07) and conventional training (isometric and weight-based equipment) (SMD: 0.88; 95% CI: 0.50-1.25), demonstrating small and moderate effect sizes respectively. Additionally, both protocols of duration 5-7 weeks (SMD: 1.16, 95% CI: 0.63-1.69) as well as those of duration ≥8 weeks (SMD: 0.57, 95% CI: 0.20-0.94) showed a significant difference.
CONCLUSIONS: Resistance training is effective in improving muscle strength of the knee and elbow extensors in PWH. Both elastic resistance and conventional training show benefits.
摘要：
背景：尽管血友病（PWH）患者经常接受阻力训练，以前没有荟萃分析量化这种干预对肌肉力量的影响，也不影响干预的方式和持续时间。
目的：（1）确定抗阻训练对血友病成人肌肉力量的影响；（2）确定运动方案中最有效的持续时间和方式。
方法：在PubMed进行了从开始到2023年11月28日的系统搜索，Embase,WebofScience,CENTRAL和CINAHL数据库。我们纳入了随机对照试验或前后研究，这些研究涉及没有其他物理治疗共同干预的阻力训练。研究选择，数据提取和偏倚风险评估由两名评审员独立进行.与第三作者协商解决了分歧。根据GRADE方法确定证据水平。
结果：纳入7项研究。荟萃分析中包括膝关节伸肌强度和肘关节伸肌强度的测量。亚组分析显示，弹性阻力方案（SMD：0.54;95％CI：0.02-1.07）和常规训练（等距和基于体重的设备）（SMD：0.88;95％CI：0.50-1.25）均有显着影响，分别展示小效应大小和中等效应大小。此外,持续时间5-7周(SMD:1.16,95%CI:0.63-1.69)和持续时间≥8周(SMD:0.57,95%CI:0.20-0.94)的方案均有显著差异.
结论：抗阻训练可有效提高PWH患者膝关节和肘关节伸肌的肌力。弹性阻力和常规训练都显示出好处。
目的：（1）确定抗阻训练对血友病成人肌肉力量的影响；（2）确定运动方案中最有效的持续时间和方式。
方法：在PubMed进行了从开始到2023年11月28日的系统搜索，Embase,WebofScience,CENTRAL和CINAHL数据库。我们纳入了随机对照试验或前后研究，这些研究涉及没有其他物理治疗共同干预的阻力训练。研究选择，数据提取和偏倚风险评估由两名评审员独立进行.与第三作者协商解决了分歧。根据GRADE方法确定证据水平。
结果：纳入7项研究。荟萃分析中包括膝关节伸肌强度和肘关节伸肌强度的测量。亚组分析显示，弹性阻力方案（SMD：0.54;95％CI：0.02-1.07）和常规训练（等距和基于体重的设备）（SMD：0.88;95％CI：0.50-1.25）均有显着影响，分别展示小效应大小和中等效应大小。此外,持续时间5-7周(SMD:1.16,95%CI:0.63-1.69)和持续时间≥8周(SMD:0.57,95%CI:0.20-0.94)的方案均有显著差异.
结论：抗阻训练可有效提高PWH患者膝关节和肘关节伸肌的肌力。弹性阻力和常规训练都显示出好处。
