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Anaemia
Presented by: Arshaad
BSc Hons (Biology),
currently B Sport Sci Hons (Biokinetics)
for further info contact (083) 379 3056 / email. [email protected]
Anaemia – Defined simply
Results in inadequate O2 supply
The inadequate production of RBC’s or Hb
Normal
Lower than normal
Anaemia – Causes
Generally there are 3 main causes
1. Excessive blood loss
2. Lack of RBC production
3. High rates of RBC destruction
Fe def
SCA
Sickle Cell Anaemia
Anaemia – SCA
Previously…
Why would an apparently normal looking individual suddenly develop SCA?
SCA is a recessive gene
Anaemia – SCA
Genotype (h h) SCA
Genotype (H h) Normal-Carrier
Genotype (H H) Normal100%
25%
SCA is a recessive gene
Anaemia – SCA
Identified at birth
SCA precipitates as a result of EXTREME EXHERTION associated dehydration
Anaemia – SCA
SCA – Response to Ex
Develop regional hypoxia
Lactic Acidosis
Hyperthermia
The above all deoxygenation
O2
O2
O2
Polymerisation Sickling
Limit Ex duration
SCA – Response to Ex
Pulmonary Response
>> Prone to chronic pulmonary impairment-Due to infections as a result of ↓immunity -Vasoocclusion ↓blood supply to the lung
>> Higher Breathing rate
>> ↓FEV1, FVC, TLC and Dead space
SCA – Response to Ex
Cardiac responseQ ≈ SV, ↓HRVentricular hypertrophy
(L & R)Septum hypertrophy
This coupled withHypoxia, pulmonary P and
potential arrhythmias lead to metabolically impaired heart
Iron Deficiency Anaemia
Anaemia – Defined simply
Fe Def – Response to Ex
• Breathlessness post mild ex
• Recovery time
• Feeling “run down”
• ↓Thermoregulation
Anaemia – General Symptoms
• Fatigue
• Headaches
• Faintness
•Breathlessness post mild ex• ↓ immune function
• Recovery time
• Feeling “run down”
• Asymptomatic with poor blood analysis (↓Fe ↓Hb)
Non specific symptoms
Exercise Testing and Prescription
Ex prescription
Follow ACSM’s general guidelines
1. Obtain medical clearance
2. Baseline testing:
>> Cardiovascular Endurance>> Muscle Strength & Endurance>> Flexibility
Ex prescription
Cardiovascular testing
Poor VO2 max at start
Sub maximal testing eg 6 min walkRecord Distance (m), age (yrs), weight (kg), height (cm) and RPP VO2= [0.02x(m)]-[0.191x(yrs)]-[0.07x(kg)]+[0.09x(cm)]+[(0.26xRPPx10-3]+2.45 VO2
∆ L
acta
te
Elite Athlete
3.5 61.5
Normal healthyTrained individualAnaemicHeart patient
Ex prescription
Muscular Strength Static
Hand grip strength
Ex prescription
Muscular Strength Dynamic
1 RM’s, 4- or 8RM’s (BP and LP)
Ensure the person is familiar with activity prior to testing.
Determine within 4 reps, start @ ±50-70%Ensure constant speed and full ROM
Ex prescription
Muscular Strength Dynamic
Isokinetic testing
60o/sec
Ex prescription
Muscular Endurance
1 min push up test
1 min curl up test
Ex prescription
Body Composition
Fat free mass
HeightWeightBMIWHRSkinfolds
Ex prescription
Follow ACSM’s general guidelines
1. Obtain medical clearance
2. Baseline testing:
>> Cardiovascular Endurance >> Muscle Strength & Endurance >> Flexibility
3. Identify Patient Goals
>> Weight loss >> General conditioning>> Athletic training
4. Prescribe programme (FITT)>> Address dietary issues (Fe intake)>> Ensure proper hydration, adequate rest
Ex prescription
Jones et al (1996) “Awareness and Identification of Athletes With Sickle Cell Disorders at Historically Black Colleges and Universities” Journal of Athletic Training 31(3):220-222
LeMura. M.L and Von Duvillard. S.P (2004) Clinical Exercise Physiology Application & Physiological principles
McArdle et al. (2007) Exercise Physiology 6th edition
Myers et al (2002) ACSM’s Resources for Clinical Exercise Physiology
Thompson et al (2009) ACSM’s Guidelines for Exercise Testing and Prescription 8 th Ed
http://www.nhlbi.nih.gov/health/dci/Diseases/anemia/anemia_whatis.htmlhttp://www.sportsdoctor.com/articles/anemia.html http://www.emedicinehealth.com/anemia/article_em.htm http://ghr.nlm.nih.gov/condition=sicklecelldisease
WHO (2008) World wide Prevalence of Anemia 1993-2005
References
