Evaluation of a Training Program for Homozygous Sickle Cell Disease Patients
Evaluation of a Training Program for Homozygous Sickle Cell Disease Patients
Sickle cell disease (SCD) is the most frequent inherited disease in the world. Literature
 reports that SCD patients display intolerance to exercise, important muscle weakness and
 profound remodeling of skeletal muscle including amyotrophy and rarefied microvascular
 network.

 Because strenuous exercise induces acidosis, hemorheological alterations, endothelial
 activation and oxidative stress, it constitutes a potential triggering factor of sickling and
 vaso-occlusive crisis. As a consequence, physical activity is usually discouraged in patients
 with SCD. However, moderate and regular physical activity seems to be not only safe but also
 beneficial for SCD patients.
Besides, endurance training is known to induce moderate muscle hypertrophy and increase
 microvascular network. Therefore, adapted, moderate and regular physical activity appears as
 a potential strategy able to improve muscle function, decrease symptoms of the disease and
 improve autonomy and quality of life of patients with SCD. However, it remains necessary to
 define the modalities of exercise therapy in SCD and to objectively evaluate the risks,
 limitations and gains on physical ability, muscle function and quality of life in patients
 with SCD.
Inclusion Criteria:

 -  Sickle cell disease patient (HbSS or HbS-βthal0),

 -  Affiliated to a Health Security program,

 -  Consent form signed,

 -  Patients in stabilized state at the onset of the experiment: at least one month after
 an acute adverse event and at least 3 months after a blood transfusion.

 Exclusion Criteria:

 -  Patients whom adhesion/compliance to the protocol appears uncertain,

 -  Patient involved in another clinical trial or within the exclusion period of a
 previous clinical trial,

 -  Patients known to be affected by a chronic inflammatory or infectious pathology,

 -  Patients having an intercurrent infection, especially inflammatory, unsolved since
 less than one month,

 -  Patients with clinical signs of heart failure or hospitalized for cardiac
 decompensation during the past 12 months,

 -  Patients with left ventricular ejection fraction < 50%, pulmonary arterial
 hypertension with tricuspid regurgitation velocity > 2.5 m/s, atrial fibrillation,
 ventricular rhythm disorders during exercise, left ventricular hypertrophy (septal to
 lateral wall thickness ≥ 10 mm), significant valvulopathy, established coronary
 disease, uncontrolled hypertension,

 -  Patients with a treatment against cardiac arrhythmia or altering sino-atrial node
 activity (beta-blockers, atropine, sympathomimetic agents…),

 -  Patients under anti-coagulant treatment,

 -  Patients with pacemaker or defibrillator,

 -  Body Mass Index (BMI) > 35,

 -  Patients with hip osteonecrosis,

 -  Patients with cerebral vasculopathy or history of stroke (cerebrovascular attack) with
 epilepsy,

 -  Pregnant or lactating patients,

 -  Homeless patients,

 -  Patients with the inability to understand the aims,