Optimizing Physical Exercise for Chronic Pain Relief in Hemophilia Patients.

AIM: To investigate the efficacy and safety of physical exercise (PE) in managing chronic pain in adults with hemophilia. METHODS: A systematic review was conducted on literature published from December 2014 to August 2025, encompassing clinical decision documents, practice guidelines, systematic reviews, and expert consensus statements. Methodological quality was assessed using the JBI appraisal tools, and evidence was synthesized thematically to generate best-evidence statements. RESULTS: Sixteen publications were included, resulting in 33 best-evidence statements categorized into six domains. PE was found to effectively reduce pain, improve physical function, and enhance well-being, with a favorable safety profile under prophylactic treatment support. CONCLUSIONS: Significant benefits can be achieved when PE interventions are implemented and adhered to in adults with hemophilia, effectively supporting chronic pain management. This study provides a scientific basis for designing individualized exercise programs, highlighting the importance of multimodal approaches and collaborative, tailored interventions.