Subjective Responses and Metabolic State during Exercise in SIckle Cell Anemia

镰状细胞贫血患者运动期间的主观反应和代谢状态

• 批准号: 8969827
• 负责人: Suzanne W Ameringer
• 金额: $ 19.06万
• 依托单位: VIRGINIA COMMONWEALTH UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-25 至 2017-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8969827
• 关键词: Adolescent and Young Adult; Aerobic; Affect; African; Anaerobic Threshold; Anemia; Bicycling; Biological Markers; Cardiac; Cardiopulmonary; Cardiovascular system; Cell Respiration; Chronic; Chronic Disease; Cues; Data; Disease; Emotions; Exercise; Exertion; Fatigue; Foundations; Functional disorder; Future; Gases; Genetic; Guidelines; Health; Health Promotion; Hematological Disease; Hemolytic Anemia; Individual; Inflammation; Informal Social Control; Intervention; Lead; Length; Life; Life Expectancy; Literature; Lung; Measures; Metabolic; Metabolism; Moderate Exercise; Monitor; Musculoskeletal; Obesity; Organ; Outcome; Pain; Perception; Performance; Phase; Physical activity; Protocols documentation; Psyche structure; Publishing; Recommendation; Regimen; Reporting; Research; Rest; Risk; Role; Self Management; Sickle Cell; Sickle Cell Anemia; Strategic Planning; Strenuous Exercise; Symptoms; Testing; Time; deconditioning; excessive exercise; exhaustion; experience; fitness; improved; interest; peer; physical conditioning; prevent; programs; public health relevance; recessive genetic trait; response; sickling; theories; trend; young adult

 DESCRIPTION (provided by applicant): Sickle cell anemia (SCA) is a genetic, life-limiting disease in which chronic anemia, sickled red blood cells, and inflammation cause debilitating pain and fatigue, and long-term complications to bodily organs. As newer treatments extend survival, a greater focus on health promotion is critical. Exercise, an important component of health promotion, is challenging in SCA because of complications associated with chronic anemia. Whereas strenuous exercise is contraindicated because it can lead to painful vaso-occlusive crises, mild to moderate exercise is recommended. Yet individuals with SCA tend to be less active and fit than healthy peers; thus are at greater risk for poorer health outcomes including obesity and cardiovascular problems. The problem is that individuals with SCA have difficulty self-managing (monitoring and self-regulating) their exercise regimen because existing exercise guidelines focus only on how to avoid potential complications. There are no guidelines on how to safely and effectively improve fitness or exercise capacity. For example, individuals with SCA are instructed to stop exercising when they begin to feel fatigued as a way of avoiding strenuous exercise because, theoretically, fatigue indicates a transition in metabolic state from aerobic to anaerobic metabolism. Being in an anaerobic metabolic state for any length of time can lead to vaso-occlusive crises. However, what the perception of fatigue during exercise represents is unknown. Does perceived fatigue indicate an anaerobic state, deconditioning, an emotion, or a combination of these factors? There are other subjective responses that may be more useful for guiding exercise intensity. In healthy individuals, subjective responses to exercise (perceptions of what one feels [effort] and how one feels [affect]) in relation to metabolic state are used to guide exercise prescription. We will study how fatigue and these subjective responses to exercise align with metabolic state to determine the ideal subjective response/s to help guide the self-management of safe and efficacious exercise in adolescents and young adults (AYA) with SCA. The hypothesis is that perceived effort and affect may align more closely to metabolic state than perceived fatigue. To test this hypothesis, AYA with SCA will complete an exercise session that involves an incremental bicycle test to volitional exhaustion (until they feel they cannot continue). The biomarker of metabolic state will be gas exchange threshold. Subjective responses that will be measured are effort, affect, and fatigue. Subjective responses will be examined in relation to metabolic state. The long-term objectives are to identify improved approaches to self-managing safe exercise intensities that are both inexpensive and efficient, and that can be used in testing future exercise interventions for AYA with SCA. Also, long-term, the aim is to determine whether exercise can have short-term benefits, such as improving SCA pain and fatigue; and long-term benefits, such as delaying or decreasing cardiopulmonary complications. Improving self-management in chronic illness is in NINR's strategic plan. This study will lay the foundation for developing a program of health promotion research in individuals with SCA.

 描述（由申请人提供）：镰状细胞性贫血（SCA）是一种遗传性、限制生命的疾病，其中慢性贫血、镰状红细胞和炎症会导致衰弱性疼痛和疲劳，以及身体器官的长期并发症。治疗可以延长生存期，但更加注重健康促进至关重要，运动是健康促进的重要组成部分，但由于与慢性贫血相关的并发症，运动是一项挑战，但剧烈运动是禁忌的，因为它会导致疼痛。血管闭塞性危机时，建议进行轻度至中度运动，但患有 SCA 的人往往比健康人更缺乏活力和健康；因此，患有肥胖症和心血管问题的健康状况较差的风险更大。自我管理（监控和自我调节）他们的运动方案，因为现有的运动指南只关注如何避免潜在的并发症，没有关于如何安全有效地提高健身或运动能力的指南。当他们开始锻炼时就停止感到疲劳是避免剧烈运动的一种方式，因为从理论上讲，疲劳表明代谢状态从有氧代谢状态转变为无氧代谢状态，任何时间都可能导致血管闭塞危机。运动过程中对疲劳的感知是未知的。感知到的疲劳是否表明无氧状态、失调、情绪或这些因素的组合？还有其他主观反应可能对指导运动强度更有用。在健康个体中，与代谢状态相关的对运动的主观反应（对运动感觉[努力]和感觉[影响]的感知）被用来指导运动处方。我们将研究疲劳和这些对运动的主观反应如何协调一致。代谢状态，以确定理想的主观反应，以帮助指导患有 SCA 的青少年和年轻人 (AYA) 进行安全有效的运动的自我管理。假设认为，感知的努力和情感可能比感知的代谢状态更接近。为了检验这个假设， AYA 与 SCA 将完成一个锻炼课程，其中包括对意志力衰竭进行增量自行车测试（直到他们感觉无法继续）。代谢状态的生物标志物将是气体交换阈值，将测量的主观反应包括努力、情感和疲劳。将检查与代谢状态相关的主观反应。长期目标是确定廉价且有效的自我管理安全运动强度的改进方法，并可用于测试未来 AYA 与 SCA 的运动干预措施。此外，从长远来看，目的是确定运动是否具有短期益处，例如改善心脏骤停疼痛和疲劳；以及长期益处，例如改善慢性疾病的自我管理。 NINR 的战略计划中，这项研究将为制定 SCA 患者的健康促进研究计划奠定基础。