Physical Activity and Pain in Youth With Sickle Cell Disease

Abstract

Study objectives were to examine the relationships between physical activity, pain, and psychological distress in youth 8 to 17 years of age with sickle cell disease. Participants were 206 youth with sickle cell disease (M = 11.73 years, 54.9% female, 99.5% African American). Caregivers and youth completed a clinical psychosocial screening battery. Results revealed frequent pain (37.6%), moderate median pain intensity, and elevated median pain interference in youth. Lower caregiver-reported physical activity was associated with worse pain outcomes. Increased anxiety was also associated with worse pain outcomes. A better understanding of the relationship between physical activity/inactivity and pain will guide multifactorial treatment interventions.

Acute Care Physical Therapy and Sickle Cell Disease

“…24 Increased anxiety is associated with worse pain outcomes for youth with SCD. 21 A relationship between emotional components of pain and the use of relaxation techniques should be considered. 21 Breathing Exercises When VOCs occur in the ribs, sternum, or back, patients without adequate pain control are at risk of hypoventilation and development of acute chest syndrome (ACS).…”

“…21 A relationship between emotional components of pain and the use of relaxation techniques should be considered. 21 Breathing Exercises When VOCs occur in the ribs, sternum, or back, patients without adequate pain control are at risk of hypoventilation and development of acute chest syndrome (ACS). 25,26 Sickling in ACS occurs within the lung tissue and vasculature as a result of atelectasis, pneumonia, or pulmonary edema, and is one of the leading causes of preventable death in pediatric patients with SCD.…”

“…Physical activity reduces the occurrence of VOC by lessening oxidative stress, promoting anti-inflammatory effects, and improving endothelial function. 41 Increased pain is associated with reduced physical activity, 21 highlighting the need for PTs to provide education to prevent future VOCs. Physical therapists are well positioned to provide information and suggest referrals for services in the post-acute setting while preparing for discharge.…”

Sickle cell disease is a global prototype for integrative research and healthcare

“…Factors influencing SCD pain were synthesized from the literature and organized into 4 domain clusters: (1) Biological/Clinical, 12,13,[28][29][30][34][35][36][37][38][39] (2) Structural/Environmental, 13,27,[31][32][33]40,41 (3) Psychosocial, 42,43 and (4) Behavioral. [44][45][46] Understanding how factors converge and precipitate or influence SCD complications longitudinally is critical in modeling the complexity of SCD and the processes through which phenotypic variations in outcomes such as pain are expressed. 47 Temporal modeling of gene-environment interactions in disease trajectory can be accomplished with tools such as observational data, medical records, and genomic/transcriptomic analysis.…”

“…Focusing on pain, the most common complication of SCD, we constructed a preliminary conceptual model (Figure 2) from our theoretical framework. Factors influencing SCD pain were synthesized from the literature and organized into 4 domain clusters: (1) Biological/Clinical, 12,13,28‐30,34‐39 (2) Structural/Environmental, 13,27,31‐33,40,41 (3) Psychosocial, 42,43 and (4) Behavioral 44‐46 . Double‐headed arrows connecting the clusters indicate that all factors may display inter‐cluster relations.…”