Muscle dysfunction is associated with poorer health-related quality of life in adults with sickle cell anaemia

J Back Musculoskelet Rehabil. 2019;32(1):43-53. doi: 10.3233/BMR-171027.

Abstract

Background: It is known that episodes of microvascular obstruction and oxidative stress in sickle cell anaemia (SCA) can damage muscle tissue. As a consequence, deterioration in muscle function may potentially contribute to poor health-related quality of life (HRQoL) in subjects with SCA, particularly those who do not use long-term treatment.

Objectives: To evaluate muscle function in adults with SCA, to study the correlations between muscle function and HRQoL and to analyse the impact of hydroxyurea treatment.

Methods: Twenty-two adults with SCA and 20 matched controls were subjected to Short Form-36 (SF-36), respiratory muscle strength measurement, isometric hand grip strength (iHGS) measurement and knee isokinetic dynamometry.

Results: In relation to their healthy peers, adults with SCA had lower SF-36 scores, respiratory muscle strength and iHGS. Regarding the isokinetic test, adults with SCA showed lower values, especially in the variables measured in flexion and with an angular velocity of 240∘/s. There was a significant correlation between the peak torque (PT) at 240∘/s and the physical component summary (SF-36PCS) in both extension (r= 0.77; p< 0.001) and flexion (r= 0.82; p< 0.001). Significant correlations were also observed between the agonist/antagonist ratio at 240∘/s and the SF-36PCS (r= 0.50; p< 0.001). The use of hydroxyurea led to higher scores on the SF-36 and higher values in knee isokinetic dynamometry.

Conclusions: Adults with SCA have muscle dysfunction, especially with regard to endurance of the knee flexor muscles. In these patients, there is a significant association between muscle function and HRQoL. Moreover, the use of hydroxyurea is associated with better HRQoL and less muscle dysfunction.

Keywords: Sickle cell anaemia; isokinetic dynamometry; muscle strength; rehabilitation.

MeSH terms

  • Adult
  • Anemia, Sickle Cell / physiopathology*
  • Case-Control Studies
  • Cross-Sectional Studies
  • Female
  • Hand Strength*
  • Humans
  • Knee / physiology
  • Knee Joint / physiology
  • Male
  • Muscle Strength / physiology
  • Muscle, Skeletal / physiology*
  • Quality of Life*
  • Range of Motion, Articular
  • Respiratory Muscles / physiopathology*
  • Torque
  • Young Adult