Email this article 
Effects of Aquatic Exercise on Dimensions of Quality of Life and Blood Indicators in Patients with Beta‑Thalassemia Major
Abstract
Background: Thalassemia is considered as a group of genetic blood disorders, characterized by
anemia. The present research aimed at evaluating the effects of aquatic exercise on quality of
life and blood indices in patients with beta‑thalassemia major.
Methods: A clinical trial study involving 40 patients with thalassemia major, divided into two groups: experimental and control.
The tools used to collect the data included demographic information questionnaire, blood indicators
questionnaire, and SF‑36 quality of life questionnaire. The experimental group performed exercise
in water three times per week for 8 weeks in the pool after obtaining the consent. In this research,
the quality of life questionnaire was filled out 24 h before the intervention, 24 h after the last session
of the exercise program, and 2 months after the end of the exercise program.
Results: The current research revealed that exercise in water affected the quality of life, hemoglobin, hematocrit, iron
and ferritin of serum such that the mean score of quality of life and blood indicators in the study
showed a significant difference in the experimental group.
Conclusions: The use of a regular exercise program combined with drug therapy and blood transfusion can be useful in the treatment
of beta‑thalassemia patients.
Keywords
Full Text:
PDFReferences
Ghodekar S, Grampurohit N, Kadam S, Thorat R. Thalassemia:
A review. Int J Pharma Res Dev 2010;2:101‑8.
Piga AG, Pignatti M, Gamberini MR, Ersi Voskaridou M,
Vincenzo Caruso M, Aldo Filosa M, et al., editors.
Luspatercept (ACE‑536) Increases Hemoglobin and Decreases
Transfusion Burden and Liver Iron Concentration in Adults with
Beta‑Thalassemia: Preliminary Results from a Phase 2 Study.
Ferrata Storti Foundation Via Giuseppe Belli 4, 27100 Pavia,
Italy: Haematologica; 2015.
Majdi M, Marzabadi A. Quality of life in Iranian Beta‑thalassemia
major patients of southern coastwise of the Caspian Sea. Int J
Behav Sci 2009;2:325‑32.
Lo YD, Chan KA, Sun H, Chen EZ, Jiang P, Lun FM, et al.
Maternal plasma DNA sequencing reveals the genome‑wide genetic
and mutational profile of the fetus. Sci Transl Med 2010;2:61‑91.
Abolghasemi H, Amid A, Zeinali S, Radfar MH, Eshghi P,
Rahiminejad MS, et al. Thalassemia in Iran: Epidemiology,
prevention, and management. J Pediatr Hematol Oncol
;29:233‑8.
Li B, Zhang XZ, Yin AH, Zhao QG, Wu L, Ma YZ, et al. High
prevalence of thalassemia in migrant populations in Guangdong
Province, China. BMC Public Health 2014;14:905.
Ghazanfari Z, Arab M, Forouzi M, Pourabouli B. Knowledge
level and education needs of thalassemic childern’s parents of
Kerman city. Iran J Crit Care Nurs 2010;3:99‑103.
Najafpour M, Farshdousti-Hagh M, Movasagpoor-Akbari AK,
Hosein-Poor Feyzi AA, Malaki M. Renal damages in patients
with major β-thalassemia. J Nephropharmacol 2020;9:e02.
Rund D, Rachmilewitz E. β‑Thalassemia. N Engl J Med
;353:1135‑46.
Rezaei N, Ghasemian A, Zareiy S, Sobhani S, Modirian M.
Burden of hemoglobinopathies (Thalassemia, sickle cell
disorders and G6PD deficiency) in Iran, 1990‑2010: Findings
from the Global Burden of Disease Study 2010. Arch Iran Med
;18:502‑7.
Zamani R, Khazaei S, Rezaeian S. Survival analysis and
its associated factors of Beta thalassemia major in hamadan
province. Iran J Med Sci 2015;40:233‑9.
Rahimi Z, Raygani AV, Merat A, Haghshenass M, Gerard N,
Nagel R, et al. Thalassemic mutations in southern Iran. Iran J
Med Sci 2015;31:70‑3.
Caocci G, Efficace F, Ciotti F, Roncarolo MG, Vacca A, Piras E,
et al. Health related quality of life in Middle Eastern children
with beta‑thalassemia. BMC Blood Disord 2012;12:6.
Maheri A, Sadeghi R, Shojaeizadeh D, Tol A, Yaseri M,
Ebrahimi M. Associations between a health‑promoting lifestyle
and quality of life among adults with beta‑thalassemia major.
Epidemiol Health 2016;38:e2016050.
Seyedifar M, Dorkoosh FA, Hamidieh AA, Naderi M, Karami H,
Karimi M, et al. Health‑related quality of life and health utility
values in beta thalassemia major patients receiving different
types of iron chelators in Iran. Int J Hematol Oncol Stem Cell
Res 2016;10:224‑31.
Baraz S, Miladinia M, Mosavinouri E. A comparison of quality
of life between adolescences with beta thalassemia major and
their healthy peers. Int J Pediatr 2016;4:1195‑204.
Schuch FB, Vancampfort D, Rosenbaum S, Richards J, Ward PB,
Stubbs B. Exercise improves physical and psychological quality
of life in people with depression: A meta‑analysis including
the evaluation of control group response. Psychiatry Res
;241:47‑54.
Kitzman DW, Brubaker P, Morgan T, Haykowsky M, Hundley G,
Kraus WE, et al. Effect of caloric restriction or aerobic exercise
training on peak oxygen consumption and quality of life in obese
older patients with heart failure with preserved ejection fraction:
A randomized clinical trial. JAMA 2016;315:36‑46.
Dziubek W, Bulińska K, Rogowski Ł, Gołębiowski T, Kusztal M,
Grochola M, et al. The effects of aquatic exercises on physical
fitness and muscle function in dialysis patients. Biomed Res Int
;2015:912980.
Latimer‑Cheung AE, Pilutti LA, Hicks AL, Ginis KA, Fenuta AM,
MacKibbon KA, et al. Effects of exercise training on fitness, mobility, fatigue, and health‑related quality of life among adults
with multiple sclerosis: A systematic review to inform guideline
development. Arch Phys Med Rehabil 2013;94:1800‑28.e3.
Kargarfard M, Fayyazi Bordbar MR, Alaei S. Effect of
eight‑week aquatic exercise on life‑quality of women over 65.
Iran J Obstet Gynecol Infertil 2012;15:1‑9.
Ortega E, Bote M, Giraldo E, García J. Aquatic exercise
improves the monocyte pro-and anti-inflammatory cytokine
production balance in fibromyalgia patients. Scand J Med Sci
Sports 2012;22:104‑12.
Kargarfard M, Etemadifar M, Baker P, Mehrabi M,
Hayatbakhsh R. Effect of aquatic exercise training on fatigue and
health‑related quality of life in patients with multiple sclerosis.
Arch Phys Med Rehabil 2012;93:1701‑8.
Arian M, Memarian R, Vakilian F, Badiee Z. Impact of an
‑week walking program on quality of life in patients with
thalassemia major. Feyz J Kashan Univ Med Sci 2013;17:463‑70.
Hoffman R, Benz EJ Jr, Silberstein LE, Heslop H, Anastasi J,
Weitz J. Hematology: Basic Principles and Practice. Elsevier
Health Sciences; 2013.
Eshaghi S‑R, Ramezani MA, Shahsanaee A, Pooya A. Validity
and reliability of the Short Form‑36 Items questionnaire as a
measure of quality of life in elderly Iranian population. Am J
Appl Sci 2006;3:1763‑6.
Montazeri A, Goshtasebi A, Vahdaninia M, Gandek B. The Short
Form Health Survey (SF‑36): Translation and validation study of
the Iranian version. Qual Life Res 2005;14:875‑82.
Sardar M, Gaeini A, Ramezani J. The effect of 8‑weeks of regular
physical activity on blood glucose, body mass index, maximal
oxygen uptake (Vo2 max) and risk factors cardiovascular
diseases in patients with type of 1 diabetes mellitus. Iran J
Endocrinol Metab 2008;10:91‑7.
Khaledi S, Moridi G, Valiee S. Comparison the quality of life of
healthy and Thalassemic children. Iran J Nurs Res 2013;8:87‑94.
Katsura Y, Yoshikawa T, Ueda S‑Y, Usui T, Sotobayashi D,
Nakao H, et al. Effects of aquatic exercise training using
water‑resistance equipment in elderly. Eur J Appl Physiol
;108:957‑64.
Heidari A, Kargarfard M, Jali M. Effects of a period of selected
aerobic exercise on the levels of hemoglobin, hematocrit and red
blood cells in pregnant women. Koomesh 2011;13:Pe127‑34.
Nahas EME, Gabr AA. Impact of aerobic exercises on
iron deficiency anemia in girls. Int J Physiother Res
;5:2399‑404.
Bateman LA, Slentz CA, Willis LH, Shields AT, Piner LW,
Bales CW, et al. Comparison of aerobic versus resistance
exercise training effects on metabolic syndrome (from the
studies of a targeted risk reduction intervention through defined
exercise‑STRRIDE‑AT/RT). Am J Cardiol 2011;108:838‑44.
Paoli A, Bianco A. Not all exercises are created equal. Am J
Cardiol 2012;109:305.
Salianeh M, Gaini A. Comparison of periodic and continuous
aerobic exercise techniques on changes in erythropoietin
hormone concentration. Q J Sport Res 2006;13:113‑22.
Heffernan KS, Fahs CA, Shinsako KK, Jae SY, Fernhall B. Heart
rate recovery and heart rate complexity following resistance
exercise training and detraining in young men. Am J Physiol
Heart Circ Physiol 2007;293:H3180‑6.
Ramezanpour MR, Kazemi M. Effects of aerobic training along
with iron supplementation on the hemoglobin, red blood cells,
hematocrit, serum ferritin, transferrin and iron in young girls.
Koomesh 2012;13:Pe233‑9.
Hosinpourmotlagh Z, Hosinikakhak A, Bakhtiar T. The effect
of resistance training and exercise on fibrinogen, plasma
concentration and blood cells in obese girls. Sport Physiol
;2:27‑37.
Eastwood A, Bourdon P, Norton K, Lewis N, Snowden K,
Gore C. No change in hemoglobin mass after 40 days of physical
activity in previously untrained adults. Scand J Med Sci Sports
;22:722‑8.
Barker A, Talevski J, Morello R, Brand C, Rahmann A,
Urquhart D. Effectiveness of aquatic exercise for musculoskeletal
conditions: A meta‑analysis. Physiotherapy 2015;101:e112‑3.
Dulfer K, Duppen N, Kuipers IM, Schokking M,
van Domburg RT, Verhulst FC, et al. Aerobic exercise influences
quality of life of children and youngsters with congenital
heart disease: A randomized controlled trial. J Adolesc Health
;55:65‑72.
Piotrowska‑Calka E. Effects of a 24‑week deep water aerobic
training program on cardiovascular fitness. Biol Sport
;27:95‑8.
Paoli A, Bianco A. What is fitness training? Definitions and
implications: A systematic review article. Iran J Public Health
;44:602‑14.
Vashtani S, Nazem F, Bordar F. The effect of aerobic
rehabilitation program on concentration of ferritin, iron,
TIBC and cardiovascular operation in the young patients
suffering from major thalassemia. J Guilan Univ Med Sci
;18:95‑102.
Hasanpour AD. Influence of yoga and aerobics exercise on
fatigue, pain and psychosocial status in patients with multiple
sclerosis: A randomized trial. J Sports Med Phys Fitness
;56:1417‑22.
Shanazari Z, Moradi MR, Mehrabi HA. Effect of aquatic training
on psychological well‑being in women with multiple sclerosis.
Knowledge Health 2015;10:19‑24.