Quality Improvement of Smartwatch-Based Exercise Monitoring in Hemophiliacs During the COVID-19 Pandemic in a Resource-Limited Nationwide Setting (Better Hemo-Life)

Background: Hemophilia is a rare X-linked bleeding disorder that commonly presents with hemarthrosis. Although the joints bleed easily, exercise is encouraged to support joint function. Unfortunately, some patients avoid exercise due to perceived barriers and a lack of motivation. Objective: This quality improvement study was conducted over 6 months to promote exercise among hemophiliacs through education, coaching, and monitoring. The primary outcome was improvement in physical fitness, includi