The effect of resistance training with and without pulsed electromagnetic field on Ca, P, total ALP and cortisol in osteoporotic severe haemophilia A

Background and Objectives Considering the Wolf law, one of the ways treating osteoporosis is to apply physical loads. In this study, we compared the effect of progressive resistive exercise versus combined resistance training with pulsed electromagnetic fields on total ALP, calcium, phosphorus, and cortisol in severe Haemophilia A with osteoporosis. Materials and Methods Thirty two severe haemophilia A patients with osteoporosis (18-35 years) were assigned randomly to a resistance training (RT), resistance training with pulsed electromagnetic field (RTPEMF), and control groups. RT group performed trunk, upper and lower limb resistance exercises (progressively, as 50-60% 1RM) for approximately 30-40 min, and RTPEMF group was exposed to 30-minute PEMF with frequency of 30 Hz, and 40 Gauss as well as 30-minute resistance training with less repetitions 3 times a week for 6 weeks. Blood total ALP, Ca, P, and cortisol was measured before and after 6 weeks. Results Cortisol level decreased significantly in Rt and RTPEMF groups (12.21 ± 6.2 and 11.65 ± 4.71, respectively) compared to the control and baseline values (20.18 ± 5.81). Total ALP also increased significantly in RT and RTPEMF groups compared to baseline values; and compared to the control group (240 ± 45) it was only RT (242 ± 43) which showed significant ALP increase. Conclusions RT is effective to improve the bone metabolism in severe haemophilia A patients with osteoporosis. Less repetition of resistive exercises to decrease the risk of hemorrhage in hemophilic patients may be compensated for by using PEMF.