25 November 2019

People with sickle cell disease may benefit from exercise more than previously thought, according to new research.

Previously it had been thought that strenuous exercise can trigger heart problems and vaso-occlusive crises in those with sickle cell disease. As a result, many patients are currently advised to avoid all forms of exercise.

But a team led by Dr Laurent Messonnier of the Université Savoie Mont Blanc in France investigated the impact of lower intensity exercise. They recruited 40 patients who were placed into two groups at random, with one group following their normal lifestyle with little physical activity, and the other undertaking an individually tailored exercise plan with three 40-minute sessions on an exercise bike three times a week. After eight weeks, the two groups were compared.

Muscle biopsies from the exercise group showed a significant increase in capillary number and density around muscle fibres. This represents a greater surface area through which oxygen and nutrients can flow between blood and muscle, say the researchers.

This study suggests that moderate-intensity exercise may help counteract the reduction of blood vessels in the muscles often seen in sickle cell disease, and improve blood and oxygen delivery to tissues.

Details were published last week in the journal Blood.

Dr Messonnier said: “When physical exercise is tailored to be light-to-moderate in intensity, the risk of problems is limited. Performed regularly, this type of exercise may induce beneficial muscle microvascular and functional adaptations that improve patients' physical abilities and quality of life.”

The team reports that “no adverse events requiring hospital admission” occurred in the training group.

Dr Messonnier adds: “The recent literature argues in favour of promotion of endurance exercise training for patients with sickle cell disease.

“However, we need to stay cautious. Before any exercise, people with sickle cell disease should be tested and receive professional guidance on what level of exercise will be safe and appropriate.”



Merlet AN, Messonnier LA, Coudy-Gandilhon C, Bechet D, Gellen B, Rupp T, Galacteros F, Bartolucci P, Féasson L (2019) “Beneficial effects of endurance exercise training on skeletal muscle microvasculature in sickle cell disease patients”, Blood, doi:10.1182/blood.2019001055