This study aims to assess the effect of endurance training on cardiorespiratory adaptations and health-related quality of life (HRQoL) of patients with sickle cell disease (SCD). Three databases (Pubmed, Embase and Web of Science) were searched from inception to September 2025. Randomized controlled trials (RCTs), Interventional Non-RCTs and case series studies assessing endurance training in SCD were included. Study selection, data extraction, and risk-of-bias assessments (using RoB 2) were performed by two independent reviewers, with discrepancies resolved by a third. Certainty of evidence was evaluated using GRADE. This review included seven studies with 176 patients with SCD engaged in different interventions of endurance training with follow-up lasting six to twelve weeks. Exercise training has favorable impact on functional capacity domain (MD 6.94; 95%CI 1.97 to 11.92) with trivial to no-effect on mental health and general health status domains of HRQoL. Exercise training seems to enhance functional capacity as demonstrated by increases in cardiorespiratory function and blood lactate levels at the first ventilatory threshold and peak oxygen consumption in RCTs and non-RCTs. Two case-series studies identified increases in the oxygen consumption at first ventilatory threshold in 15 patients (MD 1.75 ml/kg/min; 95%CI 0.73 to 2,77) after exercise training; and two RCTs identified improvements in the six-minutes walking test (MD 6.61%; 95%CI 1.42 to 11.79). Endurance exercise training improves cardiorespiratory function and HRQoL related to physical function in patients with SCD. These findings support the role of endurance exercise as complementary therapy to attenuate health risks and cardiovascular deterioration in SCD.
Keywords: Endurance training; Quality of life; Rare diseases; Sickle cell disease.
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