What is the Association of Sickle Cell Trait & Haemoglobin S Percentage with Physical Fitness?

Research Paper Title

Association of Sickle Cell Trait and Haemoglobin S Percentage with Physical Fitness.


This study aimed to determine the association between sickle cell trait (SCT) as a binary variable and haemoglobin S percentage as a stratified categorical variable with aerobic and anaerobic fitness.


This retrospective cohort study included all recruits who entered US Air Force Basic Training between January 2009 and December 2014. Fitness parameters among recruits with and without SCT were compared using a standardised fitness assessment of a 1.5-mile timed run, 1 min of push-ups, and 1 min of sit-ups. Performance was further compared by stratifying those with SCT by their haemoglobin S percentage (20%-29.99%, 30%-39.99%, and ≥40%).


Of all recruits (N = 210,461) who entered training during the surveillance period, 2,161 (1.0%) had SCT.

After adjusting for age, sex, race, body mass index, and ambient temperature while conducting the fitness assessment, recruits with SCT were slower on their initial run than their peers without SCT by a mean (standard error) of 9.4 s (2.6 s) (P < 0.001) and completed 0.5 (0.3) fewer push-ups (P < 0.05); sit-up completion was statistically equivalent between the two groups.

When retested 6 wk later, recruits with SCT improved their run time by a margin of 4.3 s (2.1 s) over their counterparts without SCT (P < 0.05).

Baseline physical fitness was largely consistent across strata of haemoglobin S percentages; increased percentages were modestly correlated with faster run times (R = 0.374) and fewer push-ups (R = 0.339).


As compared with their peers, recruits with SCT had slightly inferior aerobic fitness and similar anaerobic fitness at the outset of basic training, and gaps further narrowed over 6 wk of training.

Stratifying recruits by their haemoglobin S percentage did not dramatically change the strength or direction of association.


Webber, B.J., Uptegraft, C.C., Nye, N.S. & O’Connor, F.G. (2018) Association of Sickle Cell Trait and Hemoglobin S Percentage with Physical Fitness. Medicine and Science in Sports and Exercise. 50(12), pp.2488-2493. doi: 10.1249/MSS.0000000000001720.


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