Anaemia

Presented by: Arshaad

BSc Hons (Biology),

currently B Sport Sci Hons (Biokinetics)

for further info contact (083) 379 3056 / email. arshad.hoosen@gmail.com

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