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

基本信息

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
项目类别：
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

项目摘要

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（由适用提供）：镰状细胞性贫血（SCA）是一种遗传，生命的疾病，其中慢性贫血，镰状的红细胞和感染会导致衰弱的疼痛和疲劳，以及对身体器官的长期并发症。随着较新的治疗延长生存，对促进健康的关注至关重要。锻炼是促进健康的重要组成部分，在SCA中受到挑战，因为慢性贫血与慢性贫血有关。尽管可以导致痛苦的血管熟悉犯罪，但建议进行强大的运动，但建议进行轻度至中度的运动。然而，SCA患者比健康的同龄人往往较不活跃和健康。因此，患有肥胖和心血管问题在内的健康状况较差的风险更大。问题在于，患有SCA的人很难自我管理（监视和自我调节）其运动方案，因为现有的运动指南仅着眼于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准则。例如，当患有SCA的个体开始感到疲劳时，他们被指示停止运动，以避免强大的运动方式，因为理论上的疲劳表明，疲劳表明新陈代谢状态从有氧运动到厌氧代谢。代谢状态在任何时间内都可能导致血管熟悉的犯罪。但是，运动过程中对疲劳的看法尚不清楚。感知到的疲劳是否表明厌氧状态，衰减，情感或这些因素的组合？还有其他主题反应可能对指导运动强度更有用。在健康的个体中，主题对运动的反应（对[努力]的感受以及对代谢状态的感觉[效果]的感受）用于指导运动处方。我们将研究如何与代谢状态保持一致的疲劳和主观反应，以确定理想的主观反应，以帮助指导青少年和年轻人（AYA）使用SCA的安全有效运动的自我管理。假设是，感知的努力和影响可能比感知到的疲劳更与代谢状态保持一致。检验这一假设，AYA与SCA的AYA将完成一个涉及增量自行车测试的运动课程（直到他们认为无法继续下去）。代谢状态的生物标志物将是气体交换阈值。将测量的主观反应是有效，情感和疲劳的。将与代谢状态有关主观反应。长期目标是确定改进的自我管理的安全锻炼强度的方法，这些方法既便宜又高效，并且可以用于测试使用SCA的AYA的未来运动干预措施。而且，长期的目的是确定运动是否可以具有短期益处，例如改善SCA疼痛和疲劳；和长期益处，例如延迟或减少心肺并发症。 Ninr的战略计划是改善慢性病的自我管理。这项研究将为制定SCA患者的健康促进研究计划奠定基础。