{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T20:31:28Z","timestamp":1767990688693,"version":"3.49.0"},"reference-count":35,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2020,8,30]],"date-time":"2020-08-30T00:00:00Z","timestamp":1598745600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>In people with haemophilia (PWH), elastic band training is considered an optimal option, even though the literature is scarce. The aim was to evaluate normalized electromyographic amplitude (nEMG), rate of perceived exertion (RPE), pain, tolerability, and possible adverse effects during the knee extension exercise using multiple elastic resistance intensities in PWH. During a single session, 14 severe PWH undergoing prophylactic treatment performed knee extensions without resistance and with different intensity levels of elastic resistance. nEMG was measured for the knee extensors and participants rated their RPE, tolerability and pain intensity after each condition. Patients had to report the possible adverse effects after the session. In most of the cases, an nEMG increase is only evidenced after increasing the resistance by two to three levels. Significant associations were found between RPE and the nEMG (\u03c1 = 0.61), as well as between the elastic resistance level and nEMG (\u03c1 = 0.69) and RPE (\u03c1 = 0.71). All conditions were generally tolerated, without increased pain, and no adverse effects were reported. A wide variety of elastic resistance intensities during the knee extension are safe, tolerated, and do not increase knee pain in the majority of severe PWH undergoing prophylactic treatment.<\/jats:p>","DOI":"10.3390\/jcm9092801","type":"journal-article","created":{"date-parts":[[2020,8,30]],"date-time":"2020-08-30T22:00:17Z","timestamp":1598824817000},"page":"2801","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["EMG, Rate of Perceived Exertion, Pain, Tolerability and Possible Adverse Effects of a Knee Extensor Exercise with Progressive Elastic Resistance in Patients with Severe Haemophilia"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8670-8346","authenticated-orcid":false,"given":"Joaqu\u00edn","family":"Calatayud","sequence":"first","affiliation":[{"name":"Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain"},{"name":"National Research Centre for the Working Environment, 2100 Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jon\u00e1s","family":"Navarro-Navarro","sequence":"additional","affiliation":[{"name":"Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0740-3772","authenticated-orcid":false,"given":"Juan J.","family":"Carrasco","sequence":"additional","affiliation":[{"name":"Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain"},{"name":"Intelligent Data Analysis Laboratory, University of Valencia, 46100 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0841-5767","authenticated-orcid":false,"given":"Sof\u00eda","family":"P\u00e9rez-Alenda","sequence":"additional","affiliation":[{"name":"Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3835-3368","authenticated-orcid":false,"given":"Carlos","family":"Cruz-Montecinos","sequence":"additional","affiliation":[{"name":"Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain"},{"name":"Laboratory of Clinical Biomechanics, Department of Physical Therapy, Faculty of Medicine, University of Chile, 8380453 Santiago, Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2777-8085","authenticated-orcid":false,"given":"Lars L.","family":"Andersen","sequence":"additional","affiliation":[{"name":"National Research Centre for the Working Environment, 2100 Copenhagen, Denmark"},{"name":"Sport Sciences, Department of Health Science and Technology, Aalborg University, 9220 Aalborg East, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felipe","family":"Querol-Giner","sequence":"additional","affiliation":[{"name":"Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4391-960X","authenticated-orcid":false,"given":"Jos\u00e9","family":"Casa\u00f1a","sequence":"additional","affiliation":[{"name":"Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,8,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1542\/pir.34.7.289","article-title":"Hemophilia: In review","volume":"34","author":"Zimmerman","year":"2013","journal-title":"Pediatr. Rev."},{"key":"ref_2","first-page":"406096","article-title":"Experience of Preimplantation Genetic Diagnosis for Hemophilia at the University Hospital Virgen Del Roc\u00edo in Spain: Technical and Clinical Overview","volume":"2015","author":"Borrego","year":"2015","journal-title":"Biomed Res. Int."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1365-2516.2012.02909.x","article-title":"Guidelines for the management of hemophilia","volume":"19","author":"Srivastava","year":"2013","journal-title":"Haemophilia"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1007\/s11420-009-9140-9","article-title":"Musculoskeletal complications of hemophilia","volume":"6","year":"2010","journal-title":"HSS J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1298\/jjpta.Vol18_003","article-title":"Joint function and arthropathy severity in patients with hemophilia","volume":"18","author":"Goto","year":"2015","journal-title":"J. Jpn. Phys. Ther. Assoc."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1111\/hae.13938","article-title":"The effect of resistance exercise on strength and safety outcome for people with haemophilia: A systematic review","volume":"26","author":"Wagner","year":"2020","journal-title":"Haemophilia"},{"key":"ref_7","first-page":"1","article-title":"Exercise for haemophilia (Review)","volume":"1","author":"Strike","year":"2016","journal-title":"Cochrane Libr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1055\/s-0031-1286292","article-title":"Haemophilia and exercise","volume":"33","author":"Souza","year":"2012","journal-title":"Int. J. Sports Med."},{"key":"ref_9","first-page":"e119","article-title":"Physical exercise, pain and musculoskeletal function in patients with haemophilia: A systematic review","volume":"22","author":"Valderramas","year":"2016","journal-title":"Haemophilia"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1093\/ptj\/pzz146","article-title":"Electromyographic and Safety Comparisons of Common Lower Limb Rehabilitation Exercises for People with Hemophilia","volume":"100","author":"Calatayud","year":"2020","journal-title":"Phys. Ther."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1093\/ptj\/pzy136","article-title":"Upper-Body Exercises With External Resistance Are Well Tolerated and Enhance Muscle Activity in People with Hemophilia","volume":"99","author":"Calatayud","year":"2019","journal-title":"Phys. Ther."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Calatayud, J., P\u00e9rez-Alenda, S., Carrasco, J.J., Cruz-Montecinos, C., Andersen, L.L., Bonanad, S., Querol, F., Meg\u00edas-Vericat, J.E., and Casa\u00f1a, J. (2020). Safety and Effectiveness of Progressive Moderate-to-Vigorous Intensity Elastic Resistance Training on Physical Function and Pain in People with Hemophilia. Phys. Ther.","DOI":"10.1093\/ptj\/pzaa106"},{"key":"ref_13","first-page":"1","article-title":"Resistance training using different elastic components offers similar gains on muscle strength to weight machine equipment in Individuals with COPD: A randomized controlled trial","volume":"24","author":"Freire","year":"2020","journal-title":"Physiother. Theory Pract."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3389\/fphys.2017.00331","article-title":"Greater neural adaptations following high- vs. low-load resistance training","volume":"8","author":"Jenkins","year":"2017","journal-title":"Front. Physiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1929","DOI":"10.1007\/s40279-018-0951-z","article-title":"The Relationship Between Training Load and Injury in Athletes: A Systematic Review","volume":"48","author":"Eckard","year":"2018","journal-title":"Sport Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1136\/bjsports-2015-094758","article-title":"Monitoring the athlete training response: Subjective self-reported measures trump commonly used objective measures: A systematic review","volume":"50","author":"Saw","year":"2016","journal-title":"Br. J. Sports Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1879","DOI":"10.1519\/JSC.0b013e3181e501e9","article-title":"Control of resistance training intensity by the OMNI perceived exertion scale","volume":"25","author":"Naclerio","year":"2011","journal-title":"J. Strength Cond. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1111\/j.1365-2516.2006.01312.x","article-title":"Hemophilia joint health score reliability study","volume":"12","author":"Hilliard","year":"2006","journal-title":"Haemophilia"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1177\/1403494807085373","article-title":"Reliability and validity of self-reported physical activity in the Nord-Tr\u00f8ndelag Health Study\u2014HUNT 1","volume":"36","author":"Kurtze","year":"2008","journal-title":"Scand. J. Public Health"},{"key":"ref_20","unstructured":"(2020, August 14). SENIAM. Available online: http:\/\/www.seniam.org\/."},{"key":"ref_21","first-page":"606","article-title":"Muscle activity during knee-extension strengthening exercise performed with elastic tubing and isotonic resistance","volume":"7","author":"Jakobsen","year":"2012","journal-title":"Int. J. Sports Phys. Ther."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1016\/j.clinthera.2008.05.011","article-title":"Validity, reliability, and clinical importance of change in a 0-10 numeric rating scale measure of spasticity: A post hoc analysis of a randomized, double-blind, placebo-controlled trial","volume":"30","author":"Farrar","year":"2008","journal-title":"Clin Ther."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1080\/00913847.2018.1441580","article-title":"Shoulder and arm muscle activity during elastic band exercises performed in a hospital bed","volume":"46","author":"Skals","year":"2018","journal-title":"Phys. Sportsmed."},{"key":"ref_24","first-page":"811","article-title":"Perceived loading and muscle activity during hip strengthening exercises: Comparison of elastic resistance and machine exercises","volume":"8","author":"Brandt","year":"2013","journal-title":"Int. J. Sports Phys. Ther."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"van den Tillaar, R., Andersen, V., and Saeterbakken, A.H. (2019). Comparison of muscle activation and kinematics during free-weight back squats with different loads. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0217044"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"538","DOI":"10.2522\/ptj.20090167","article-title":"Muscle activation and perceived loading during rehabilitation exercises: Comparison of dumbbells and elastic resistance","volume":"90","author":"Andersen","year":"2010","journal-title":"Phys. Ther."},{"key":"ref_27","first-page":"758","article-title":"Construct and concurrent validation of a new resistance intensity scale for exercise with thera-band\u00ae elastic bands","volume":"13","author":"Colado","year":"2014","journal-title":"J. Sport Sci. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.humov.2012.07.002","article-title":"Muscle activity during leg strengthening exercise using free weights and elastic resistance: Effects of ballistic vs. controlled contractions","volume":"32","author":"Jakobsen","year":"2013","journal-title":"Hum. Mov. Sci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1007\/s40279-016-0619-5","article-title":"Training Load and Fatigue Marker Associations with Injury and Illness: A Systematic Review of Longitudinal Studies","volume":"47","author":"Jones","year":"2017","journal-title":"Sport Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2136","DOI":"10.1182\/bloodadvances.2018020552","article-title":"The frequency of joint hemorrhages and procedures in nonsevere hemophilia A vs. B","volume":"2","author":"Soucie","year":"2018","journal-title":"Blood Adv."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1111\/hae.13361","article-title":"Pattern of bleeding in a large prospective cohort of haemophilia A patients: A three-year follow-up of the AHEAD (Advate in HaEmophilia A outcome Database) study","volume":"24","author":"Khair","year":"2018","journal-title":"Haemophilia"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1589\/jpts.32.52","article-title":"Effects of resistance exercise using the elastic band on the pain and function of patients with degenerative knee arthritis","volume":"32","author":"Kim","year":"2020","journal-title":"J. Phys. Ther. Sci."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1111\/crj.12141","article-title":"Low-load\/high-repetition elastic band resistance training in patients with COPD: A randomized, controlled, multicenter trial","volume":"9","author":"Nyberg","year":"2015","journal-title":"Clin. Respir. J."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2115","DOI":"10.1007\/s00520-019-05019-1","article-title":"Adherence to and satisfaction with low-intensity physical activity and supervised moderate-high intensity exercise during chemotherapy for breast cancer","volume":"28","author":"Buffart","year":"2020","journal-title":"Support. Care Cancer"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1186\/1479-5868-9-78","article-title":"Exercise, physical activity, and self-determination theory: A systematic review","volume":"9","author":"Teixeira","year":"2012","journal-title":"Int. J. Behav. Nutr. Phys. Act."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/9\/2801\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:04:49Z","timestamp":1760177089000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/9\/2801"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,30]]},"references-count":35,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2020,9]]}},"alternative-id":["jcm9092801"],"URL":"https:\/\/doi.org\/10.3390\/jcm9092801","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,30]]}}}