EXERCISE AND WELL-BEING IN WOMEN WITH SICKLE CELL ANEMIA

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DESCRIPTION (Adapted from the Applicant's Description): The proposed study's long-term goal is to determine the value of exercise for patients with sickle cell anemia (SCA). This disability is characterized by sedentariness, partly because of limitations imposed by the disability and partly because of medical conservatism. Since no information exists concerning controlled physical training (PT) in SCA patients, it is difficult for physicians to make informed recommendations to their patients concerning the value or danger of exercise. Specific aim: To determine the effect of PT on physical fitness and well-being of SCA patients. Main measurements: The primary outcome variable will be peak oxygen consump-tion. Anaerobic threshold, a submaximal and effort-independent measurement, will be used as a secondary index of aerobic fitness. The investigator will also measure muscle strength with leg and bench press tests, left ventricular dimensions and function with echocardiography, perception of well-being with the Rand-SF36 survey, and body composition with dual x-ray absorptometry. To help interpret body composition changes, he will measure resting energy expenditure by indirect calorimetry, diet with three day recalls, and free-living physical activity by seven day recall. Design: Female SCA patients (n=64) will be randomized into two groups. Group 1 will engage in PT for six months while group 2 continues in their standard care. The primary hypothesis will be tested with a random group analysis, using the "intention to treat" procedure. Physical training: PT sessions will be offered four times a week; the intent will be to have each woman attend at least three times a week. PT sessions will be comprised of aerobic and strength training. The subjects will wear heart rate monitors throughout the sessions to monitor exercise intensity, which will be kept below the level at which any undesirable signs or symptoms were observed on the baseline exercise test. Implication: This study is intended to provide new information about the effectiveness of regular exercise in improving the health and well-being of women with SCA.