Impact of a physical exercise program on the distance covered in the six-minute walk test, muscle strength and quality of life in patients with sickle cell anemia

Abstract

Introduction: Life expectancy has progressively increased in people with sickle cell anemia (SCA), which creates the need to undertake rehabilitation strategies in this population. In view of the advances in functional rehabilitation in recent decades, home physical exercises guided by a physiotherapist (HPEGP) have been increasingly used in the field of Physiotherapy for increasing patient compliance and reducing costs to the health system. Methods: To investigate the effects of HPEGP on functional capacity, muscle strength and quality of life (QoL), 40 adults with SCA submitted to HPEGP through a primer for 12 weeks. Before and at the end of the training, the participants underwent the following assessments: functional capacity through the distance covered in the 6’ walk test (6MWD); muscle strength measurements through maximal inspiratory pressure (PImax), maximal expiratory pressure (PEmax), handgrip strength (HGS) and quadriceps strength (QS); and QoL using the physical component (SF-36PC) and the mental component (SF-36MC). Results: After performing the HPEGP, significant increases were observed in the mean values of 6MWD, PImax, PEmax, FPM, FQ, SF-36CF and SF-36CM. The relative delta between pre and post HPEGP of the 6MWD 'correlated significantly with the relative delta of PImax (rs = 0.640, P <0.0001), PEmax (rs = 0.587, P <0.0001), HGS (rs = 0.360, P = 0.022) and QS (rs = 0.351, P = 0.026). When the participants were separated in relation to the use of hydroxyurea, significant increases were observed in the relative deltas of the 6MWD, PImax and PEmax values. Conclusion: Thus, HPEGP increases functional capacity, muscle strength and QoL in adults with SCA. Furthermore, there is a relationship between gains in the 6MWD and gains in respiratory and peripheral muscle strength with HPEGP.