EFFECTS OF A 12-WEEK AEROBIC EXERCISE PROGRAMME ON CARDIORESPIRATORY AND HAEMATOLOGICAL VARIABLES AND QUALITY OF LIFE OF INDIVIDUALS WITH SICKLE CELL ANAEMIA.

Abstract

Sickle Cell Anaemia (SCA) is a genetic disorder characterized by predominance of sickle cell haemoglobin. Its management is multidisciplinary but does not routinely include physiotherapy except when certain complications occur. Aerobic exercise improves cardiovascular endurance and function in sickle cell anaemia patients but its effects on their Quality of Life (QoL), Frequency of Crisis (FC), Frequency of Hospitalization (FH) and Length of Hospitalization (LH) have not been well documented.This study was designed to investigate the effects of a 12-week aerobic exercise programme on QoL, cardiorespiratory and haematological variables, FC, FH and LH of individuals with SCA. The study was a two-group randomised control trial involving 129 consecutively recruited individuals with SCA assigned to exercise (65) and control (64) groups. However, 104 participants (exercise group= 54, control group= 50) completed the study. Data on FC, FH and LH in the 6-months before the study were retrieved from participants’ hospital files. The exercise group had 12 weeks of aerobic dance exercises, comprising dancing thrice weekly; the intensity being progressed by increasing the duration by five minutes fortnightly. Data on QoL (using Short Form-36 questionnaire), cardiorespiratory variables [Heart Rate (HR), Cardiorespiratory Fitness Score (CRFS) and Vital Capacity (VC)] and haematological variables [Packed Cell Volume (PCV), Platelet Count (PC) and Mean Corpuscular Haemoglobin Concentration (MCHC)] were collected at baseline and at the ends of the 6th and 12th week. Information on FC, FH and LH during the 6-month follow-up phase was also retrieved from participants’ hospital files. Data were analysed using ANOVA, independent and paired t-tests at p ≤ 0.05. The mean ages of the exercise (26.1±6.7 years) and control (25.7±5.6 years) groups were not significantly different. At baseline, the QoL (65.1±8.2, 65.4±10.1), HR (75.2±4.5 b/min, 76.8±5.1 b/min), CRFS (52.6±4.1, 54.3±4.5) VC (1714.5±400.4 cc, 1773.9±446.5 cc), PCV (24.7±3.2 %, 24.4±3.4 %), PC (364.6±127.5×109/L, 343.6±128.8×109 /L) and MCHC (33.7±1.0 g/dl, 33.9±1.1 g/dl) for exercise and control groups were not significantly different. The exercise group compared with the control had better CRFS (50.8±5.5, 54.2±6.4 respectively), VC (2109.4±441.9cc, 1769.9±389.6cc respectively) and PCV (26.1±3.4%, 23.84±3.8% respectively). The exercise group compared with the control had better HR (71.9±3.5 b/min, 76.5±4.9 b/min), CRFS (46.5±6.2, 55.3±6.7), VC (2293.9±374.1 cc, 1755.8±377.6 cc) and PCV (26.8±3.3 %, 23.32±3.5 %) at the end of the 12th week. Although the pre-intervention variables for exercise and control groups were not significantly different for their FC (1.4±1.5, 1.4±1.7 respectively), FH (0.4±0.6, 0.4±0.6 respectively) and LH (0.6±0.9 days, 0.7±1.0 days respectively). However, the exercise group had significantly less FC (0.5±0.6), FH (0.1±0.3) and shorter LH (0.1±0.3 days) in the follow-up phase of the study. The 12-week aerobic exercise programme improved the quality of life, vital capacity and cardiorespiratory fitness score and reduced their HR, frequencies of crisis and hospitalization and length of hospitalization. Aerobic exercise should be routinely included in the total management of patients with sickle cell anaemia.