VCU news

By Angela Flagg
VCU School of Nursing

The National Institutes of Health recently awarded a $250,000 grant to Virginia Commonwealth University’s School of Nursing for a study that is the first to examine improved approaches to self-managing exercises in adolescents and young adults with sickle cell anemia.

Suzanne Ameringer, Ph.D., associate professor in the School of Nursing's Department of Family and Community Health Nursing, received the two-year NIH Exploratory/Developmental Research Grant for her project, titled "Subjective Responses and Metabolic State During Exercise in Sickle Cell Anemia."

Sickle cell anemia is a genetic, life-limiting disease in which chronic anemia, sickled red blood cells, and inflammation cause debilitating pain and fatigue, as well as long-term complications to bodily organs. In the United States, the disease affects up to 100,000 people, primarily African-Americans. Globally, it affects millions, and the number of infants born with sickle cell anemia is expected to increase by approximately 30 percent by 2050 according to a study published in the weekly medical journal PLOS Medicine.

Individuals with sickle cell anemia tend to be less active and fit than healthy peers. Thus they are at a greater risk for poorer health outcomes including obesity and cardiovascular problems, Ameringer said.  

"They have difficulty self-managing their exercise regimen because existing exercise guidelines focus only on how to avoid potential complications," she said. "There are no guidelines on how to safely and effectively improve fitness or exercise capacity."

Inactivity is associated with poorer health outcomes, yet exercise is challenging for sickle cell anemia patients because of complications associated with chronic anemia.

"They have fatigue from the constant anemia and when asked what they do for fatigue, they have not been offered many options," Ameringer said, referring to a study she conducted several years ago on fatigue and sickle cell anemia in adolescents and young adults.

They have fatigue from the constant anemia and when asked what they do for fatigue, they have not been offered many options.

The current study, which will target patients who are 15 to 30 years old from pediatric and hematology clinics at VCU Health, will help lay the foundation for helping sickle cell anemia patients to safely improve their exercise capacity and fitness.

"We know exercise can help fatigue but strenuous exercise can be potentially dangerous," she said.

The study aims 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 adolescents and young adults with sickle cell anemia.  Another goal is to determine whether exercise can have short-term benefits, such as improving pain and fatigue, and long-term benefits, such as delaying or decreasing cardiopulmonary complications.

"Better guidelines for safely and effectively exercising with sickle cell anemia may increase participation in exercise, which could potentially lead to better physical condition, improved pain and fatigue, and reduced obesity," Ameringer said.

Ameringer's interest in sickle cell anemia grew from when she cared for patients with the disease.

"This is a horrible, painful disease and I have always wanted to make life better for them if I could," she said.

Ameringer is joined on the study by R.K. Elswick Jr., Ph.D., professor and biostatistician in the Department of Family and Community Health Nursing at the VCU School of Nursing. Team members also include India Sisler, M.D., assistant professor in the Division of Hematology and Oncology at Children’s Hospital of Richmond at VCU; Edmund Acevedo, Ph.D., professor and chair of the Department of Health and Human Performance in the VCU School of Education; and Wally Smith, professor in the VCU School of Medicine and scientific director of the VCU Center on Health Disparities.

 

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