Physical Impairment and Function in Children and Adolescents With Sickle Cell Disease: A Systematic Review.
Victoria Marchese, Kelly Rock, Andria Harpold and 3 others
PMID 34592159WHAT IT FOUND
Children and adolescents with sickle cell disease show widespread physical impairments, including reduced muscle strength, lower bone density, and decreased physical activity.
Objective testing reveals deficits that self-report questionnaires may miss, suggesting clinicians should use direct measures to guide care.
Key findings
01Children and adolescents with sickle cell disease present with significant reductions in lean muscle mass, bone density, and maximal handgrip strength compared to controls.
02Physical activity levels are decreased by 24 to 58% in children and adolescents with sickle cell disease, who spend more time at lower intensity levels.
03Self-reported physical function often differs from objective measures, with children reporting higher function than caregivers, indicating a need for objective assessment.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The review was exploratory and did not exclude studies based on quality, meaning low-quality evidence was included. A meta-analysis was not possible due to the heterogeneity of study designs, participant characteristics, and outcome measures. The search was limited to English-language studies and grey literature was excluded. Most included studies were observational, limiting conclusions about causality or intervention efficacy. Only one pediatric intervention study was included, providing very limited evidence on treatment effects.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not assume that standard exercise interventions will automatically improve physical function in children with sickle cell disease. The only included intervention study showed no significant improvement in exercise parameters after 12 weeks of training, and the review notes a lack of robust evidence for specific rehabilitation programs.