Which practice supports activity tolerance in a child with sickle cell disease?

• A. Activity and rest cycling for periods of activity intolerance.
• B. Continuous high-intensity exercise
• C. No rest periods
• D. Sedentary lifestyle only

Answer: (A)

Pacing exercise with scheduled rest periods helps children with sickle cell disease build and maintain activity tolerance. In sickle cell disease, episodes of pain and crises can be triggered when oxygen delivery is stressed, especially during high metabolic demand, dehydration, or acidosis. By alternating periods of activity with rest, you allow time for oxygen delivery, hydration, and metabolic recovery, which reduces the risk of triggering sickling and gradually builds endurance.

Continuous high‑intensity exercise without breaks elevates metabolic demand and can precipitate dehydration and hypoxia, increasing the likelihood of a sickling crisis. No rest periods leave little opportunity to recover, making tolerance harder to improve. A sedentary lifestyle does not provide the progressive stimulus needed to enhance endurance.

So, alternating activity and rest is the best approach to support and gradually improve activity tolerance in a child with sickle cell disease.