Abstract
Purpose
Sickle cell disease (SCD) patients exhibit a limited exercise tolerance commonly attributed to anaemia, as well as hemorheological and cardio-respiratory abnormalities, but the functional status of skeletal muscle at exercise is unknown. Moreover, the effect of SCD genotype on exercise tolerance and skeletal muscle function has been poorly investigated. The aim of this study was to investigate skeletal muscle function and fatigue during a submaximal exercise in SCD patients.
Methods
Nineteen healthy individuals (AA), 28 patients with sickle cell anaemia (SS) and 18 with sickle cell-haemoglobin C disease (SC) performed repeated knee extensions exercise (FAT). Maximal isometric torque (Tmax) was measured before and after the FAT to quantify muscle fatigability. Electromyographic activity and oxygenation by near-infrared spectroscopy of the Vastus Lateralis were recorded.
Results
FAT caused a reduction in Tmax in SS (− 17.0 ± 12.1%, p < 0.001) and SC (− 21.5 ± 14.5%, p < 0.05) but not in AA (+ 0.58 ± 29.9%). Root-mean-squared value of EMG signal (RMS) decreased only in SS after FAT, while the median power frequency (MPF) was unchanged in all groups. Oxygenation kinetics were determined in SS and AA and were not different.
Conclusion
These results show skeletal muscle dysfunction during exercise in SCD patients, and suggest different fatigue aetiology between SS and SC. The changes in EMG signal and oxygenation kinetics during exercise suggest that the greater skeletal muscle fatigue occurring in SCD patients would be rather due to intramuscular alterations modifications than decreased tissue oxygenation. Moreover, SS patients exhibit greater muscle fatigability than SC.
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Abbreviations
- 6-MWT:
-
6-Min walk test
- AA:
-
Healthy subjects
- ACS:
-
Acute chest syndrome
- BP:
-
Blood pressure
- EMG:
-
Electromyography
- FAT:
-
Fatigability test
- GPAQ:
-
Global Physical Activity Questionnaire
- HbC:
-
Haemoglobin C
- HbS:
-
Haemoglobin S
- HR:
-
Heart rate
- iMVC:
-
Isometric maximal voluntary contraction
- MPF:
-
Median power frequency
- NIRS:
-
Near-infrared spectroscopy
- RBC:
-
Red blood cell
- RMS:
-
Root Mean Square
- RMSmax:
-
Maximal root mean square value
- RPE:
-
Perceived exertion
- SC:
-
Sickle cell-haemoglobin C disease
- SCD:
-
Sickle cell disease
- SpO2 :
-
Transcutaneous oxygen saturation
- SS:
-
Sickle cell anaemia
- Tmax:
-
Maximal isometric torque
- TSI:
-
Tissue saturation index
- VL:
-
Vastus Lateralis
- VOC:
-
Vaso-occlusive crisis
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Acknowledgements
We thank Johan Cassirame, from Mtraining, for technical support on near-infrared spectroscopy.
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Study design: PC, GC, and CH. Acquisition of data: EG and SM. Analysis and interpretation of data: EG, PC, CF, and CH. Drafting of the manuscript: EG, PC, CF, and CH. Critical revision of the manuscript: AGV, SP, CR, CB, PJ, YB, AH, and GC.
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Philippe Connes and Alexandra Gauthier-Vasserot have equivalent position.
Camille Faes—deceased.
Giovanna Cannas and Christophe Hautier are co-last authors.
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421_2021_4716_MOESM1_ESM.tif
Supplementary file 1: Figure S1A: RMS/RMSmax within each bout of the FAT for each group. Data are presented by Mean ± SD. *: p < 0.05 (TIF 180 KB)
421_2021_4716_MOESM2_ESM.tif
Supplementary file 2: Figure S1B: MPF within each bout of the FAT for each group. Data are presented by Mean ± SD. *: p < 0.05 (TIF 140 KB)
421_2021_4716_MOESM3_ESM.tif
Supplementary file 3: Figure S1C: Typical trace for TSI obtained during a bout of FAT (A). ΔTSI (B) corresponds to the difference between baseline and mean TSI during the plateau phase. Time of deoxygenation (C) is the time between the beginning of the bout and of the plateau phase (TIF 88 KB)
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Gouraud, E., Connes, P., Gauthier-Vasserot, A. et al. Impact of a submaximal mono-articular exercise on the skeletal muscle function of patients with sickle cell disease. Eur J Appl Physiol 121, 2459–2470 (2021). https://doi.org/10.1007/s00421-021-04716-2
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DOI: https://doi.org/10.1007/s00421-021-04716-2