Congenital bleeding disorders and sports in Italy: a wellbeing study

BACKGROUND: In Italy, medical certification is required before sports participation. To facilitate access to various sports disciplines for people with bleeding disorders, a multidisciplinary working group involving the Italian National Olympic Committee (CONI), Italian Sports Medicine Federation (FMSI), Italian Association of Hemophilia Centers (AICE), and the Italian Federation of Hemophilia Associations (FEDEMO) is currently elaborating recommendations in this area. METHODS: This study gathered data on access to sports activities by people with congenital bleeding disorders in Italy using a questionnaire on attitudes, preferences, and obstacles to sports access. RESULTS: The questionnaire was completed by 110 mostly current or former sports participants with bleeding disorders (mean age 31 years; all males; 74% with a serious form of disease). Interest in sports participation was high across age groups. Respondents who played sports now or previously believe it to be important for their physical or psychological wellbeing. Decisions to participate were guided by family members and/or medical professionals. Hematologists were consulted more frequently than general practitioners. Of 79 respondents who had requested medical certification for sports, 38 rated the procedure "rather difficult" (33%) or "very difficult" (15%). CONCLUSIONS: This study revealed that many people with congenital bleeding disorders are interested in playing sports. Decisions regarding sports participation by people with bleeding disorders should be made in a multidisciplinary setting, involving sports medicine and orthopedic specialists, hematologists and family practitioners who identify appropriate activities and establish individualized strategies to prevent, monitor for, and treat bleeding episodes, protecting the patient's right to a full life without exposing them to risks from inappropriate activities.