Background: Familial Mediterranean fever (FMF) is a systemic autoinflammatory disease that causes recurrent attacks of fever, polyserositis, arthritis or skin eruptions, resulting in pain in the abdomen, muscles, joints and chest. All of these might lead to a reduction in exercise capacity, muscle strength, physical activity level (PAL) and quality of life (QoL). Therefore, assesment of these parameters are important. The aim of this study was to assess exercise capacity, muscle strength, PAL and QoL in patients FMF as compared to controls. Materials and methods: 40 subjects with FMF and 36 healthy control subjects participated in the study. The 6-Minute Walk Test (6MWT) was used to assess exercise capacity. Muscle strength measurements for shoulder flexors, extensors and abductors, hip flexors, extensors and abductors, knee flexors and extensors, and ankle dorsiflexors were evaluated by hand-held dynamometer. PAL was assessed using the International Physical Activity Questionnaire-Short Form (IPAQ-SF). QoL was investigated by Nottingham Health Profile (NHP).Results: Significant differences were found between patients and healthy subjects for 6MWT (p=0.003), muscle strength of ankle dorsiflexors (p=0.001), hip flexors (p=0.047), extensors (p=0.003) and abductors (p=0.004), total scores of IPAQ-SF (p=0.004), and pain (p<0.001), physical mobility (p<0.001) and energy level (p=0.026) subscales of NHP. However, there were no significant differences between groups for the shoulder flexion (p=0.089), extension (p=0.440) and abduction (p=0.232), hand grip strength 2 (p=0.160) , and knee flexion (p=0.744) and extension (p=0.155) muscle strength and emotional reaction (p=0.088), sleep (p=0.070) and social isolation (p=0.086) subsets of NHP. Conclusion:Subjects with FMF demonstrated lower exercise capacity, muscle strength, PAL and QoL than healthy peers. Therefore, it is important to evaluate and improve these parameters in patients with FMF.
Background:The COVID-19 pandemic affects the whole world in many ways. In an effort to slow down the infection, physical distancing and isolation policies have been implemented in Turkey, likewise the rest of the world. Thereby, rheumatic diseases require to obey the self-isolation recommendations strictly due to general vulnerability to infections in those patients. Due to the precautions taken for isolation, the physical inactivity level of the patients which would affect the disease activity has increased (1).Objectives:The primary purpose of this study was to assess the exercise compliance and clinical status of the patients with rheumatic diseases during the COVID-19 pandemic. The secondary aim of the study was to evaluate the physical activity level and quality of life of the patients during the pandemic.Methods:The research is a cross-sectional study. Seventy-nine patients with various rheumatic diseases were included in the study. Standard questions were used to evaluate the exercise habits, the level of pain and morning stiffness and severity of exacerbations. Pain and morning stiffness levels and attack severity were scored on a numerical rating scale (NRS) (0-10; with 0 indicating no pain/stiffness and 10 severe pain/stiffness). Attack duration was recorded in number of exacerbated days. Parameters were compared before and after the pandemic with Paired Samples T Test. The International Physical Activity Questionnaire-Short Form (IPAQ) and Nottingham Health Profile (NHP) Questionnaire were filled to assess the physical activity level and quality of life.Results:Twenty-eight percent of the patients were diagnosed with Familial Mediterranean Fever (FMF), 37% were Ankylosing Spondylitis (AS), 14% were Systemic Sclerosis (ScS) 14% were Systemic Lupus Erythematosus (SLE), 6% were Rheumatoid Arthritis, 1% were Primary Sjogren Syndrome (PSS). Less than half of the patients (46%) did continue exercising regularly during the pandemic and 30 (81%) of them performed only the exercises given by the therapist while 7 (9%) of them tried different exercise types from another source. The reason for discontinuation to exercising expressed by the incompliant patients were mostly “unwillingness” (17 of 37 patients). Pain, morning stiffness and number of attacks were better during the pandemic compared to before however, a statistically significant difference was found only for morning stiffness (p = .036). The results of IPAQ showed that the majority of the patients (n: 48) were physically inactive, while only 2 patients were active during the pandemic. The most deteriorated quality of life subcategory was energy level of the patients according to the NHP scores.Conclusion:This study results showed that patients with rheumatic diseases stayed physically inactive during the pandemic and the disease status has also been affected negatively. As the duration of the pandemic prolongs, levels of physical inactivity would increase and the progressive physical inactivity is expected to worsen patients’ symptoms more. However, as the pandemic appears to continue, face-to-face exercise therapy should still be avoided. For all those reasons above, alternative ways of therapy like tele-rehabilitation would come onto stage to cope with the increasing physical inactivity of the rheumatic patients.References:[1]Pinto AJ, Dunstan DW, Owen N, Bonfá E, Gualano B. Combating physical inactivity during the COVID-19 pandemic. Nature Reviews Rheumatology. 2020; 16(7):1-2.Disclosure of Interests:None declared
BackgroundSystemic lupus erythematosus (SLE) is a chronic, autoimmune, inflammatory rheumatic disease that causes tissue damage through autoantibodies and immune complexes. Patients with chronic diseases such as SLE fall into a vicious circle. Fatigue and depression can negatively affect the quality of life and cause patients to stay at home and hence, be physical inactivity. As a result of physical inactivity; the exercise capacity and muscle strength of SLE patients can decrease.ObjectivesThe aim of this study is to investigate the physical activity, peripheral muscle strength, exercise capacity, sleep, fatigue, anxiety, and depression levels between patients with SLE and healthy individuals.MethodsTwenty-six patients with SLE (32.5 (24.75/43.25) years) and 29 healthy individuals (30 (23/32) years) were compared. Exercise capacity (6-minute walk test (6MWT)), peripheral muscle strength (dynamometer), physical activity (the Xiaomi Mi Band 4 smart bracelet device), fatigue (Fatigue Severity Scale (FSS)), anxiety and depression (Hospital Anxiety Depression scale (HAD)), quality of life (SLE-specific QOL scale (SLEQoL)), and sleep (Pittsburgh Sleep Quality Index (PSQI)) were assessed.ResultsDemographic characteristics were similar in both groups except for cigarette consumption (pack*years) (p>0.05). 6MWT distance, peripheral muscle strength, physical activity level, SLEQoL, and PSQI scores were significantly lower; FSS and HAD scores were higher in patients with SLE (p<0.05). Moreover; the difference between post and pretest values of heart rate, dyspnea, fatigue, and quadriceps femoris muscle fatigue was higher in patients with SLE compared to healthy individuals.ConclusionPatients with SLE had lower exercise capacity, muscle strength, quality of life, and sleep quality, and higher fatigue, anxiety, and depression. In addition; These patients were physically inactive. Further studies are needed to investigate the effects and efficiency of these symptoms on patients with SLE.References[1] Karim MY, Miranda LC, Tench CM, Gordon PA, D’Cruz DP, Khamasthta MA, Hughes GRV (2002) Presentation and prognosis of the shrinking lung syndrome in systemic lupus erythematosus. Semin Artrhitis Rheum 31:289–298.[2] Bertsias G, Ioannidis JP, Boletis J, Bombardieri S, Cervera R, Dostal C, et al. EULAR recommendations for the management of systemic lupus erythematosus. Report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics. Ann Rheum Dis 2008;67(2):195–205.[3] Ana J. Pinto, Cintia N. H. Miyake, Fabiana B. Benatti, Clovis A. Silva, Adriana M. E. Sallum, Eduardo Borba, Ana L. De S_ A-Pinto, Eloisa Bonf A, and Bruno Gualano. Reduced Aerobic Capacity and Quality of Life in Physically Inactive Patients With Systemic Lupus Erythematosus With Mild or Inactive Disease Arthritis Care & Research Vol. 68, No. 12, December 2016, pp 1780–1786.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
BackgroundVitamin D is one of the fat-soluble vitamins and is also a group of sterols that are hormone and hormone precursors. Vitamin D deficiency and/or insufficiency have been found to be associated with many chronic diseases, including cancers, metabolic syndrome, and autoimmune diseases. Vitamin D is involved in modulation of immune responses in autoimmune disorders including multiple sclerosis, asthma, diabetes mellitus, connective tissue disorders such as rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE). In addition; Previous studies conducted in other patient populations indicate that higher vitamin D levels are related to higher exercise capacity, muscle strength, and better lung function.ObjectivesThe purpose was to investigate the effects of vitamin D deficiency on exercise capacity, respiratory muscle strength, and peripheral muscle strength in patients with connective tissue disease (CTD).MethodsThis cross-sectional observational study included CDT (SLE and systemic sclerosis (SSc)) patients and healthy participants. Serum 25(OH)D, calcium, and phosphorus levels were measured and Vitamin D levels 10.0-20.0 ng/mL defined insufficiency and levels <10.0 ng/mL defined deficiency. The exercise capacity, respiratory muscle strength, and peripheral muscle strengths were set as the primary outcomes of the study. Secondary outcomes included evaluation of physical activity, dyspnea, pain, emotional status, fatigue, and quality of life.ResultsThere were 23 SLE (36.82±10.06), 21 SSc (44.38±14.63), and 24 healthy controls (37.62±11.74). Compared to healthy controls, CTD groups with vitamin D deficiency had significantly lower respiratory muscle strength (p<0.001), peripheral muscle strength (knee extension and shoulder flexion) (p<0.05), exercise capacity (p<0.05), physical activity (p<0.05), and quality of life (p<0.05) while having significantly more dyspnea (p<0.001), pain (p<0.001), fatigue (p<0.001), anxiety, and depression (p<0.05).ConclusionThe results of our study indicate that vitamin D deficiency is associated with reduced muscle strenghts and related symptoms and complaints in CTD patients, hence, in order to increase the efficacy of rehabilitation and treatment programs, attention should be paid to vitamin D levels and should be corrected approprately.References[1]Sizar O, Khare S, Goyal A, Givler A. Vitamin D Deficiency. StatPearls. Treasure Island (FL): StatPearls Publishing. Copyright © 2022, StatPearls Publishing LLC.; 2022.[2]Vaidya B, Nakarmi S. Vitamin D in Rheumatic Diseases: Interpretation and Significance. Fads and Facts about Vitamin D [Internet]. London, United Kingdom: Intech Open; 2019.[3]Hassanalilou T, Khalili L, Ghavamzadeh S, Shokri A, Payahoo L, Bishak YK (2017) Role of vitamin D deficiency in systemic lupus erythematosus incidence and aggravation. Auto Immun Highlights 9(1):1.https://doi.org/10.1007/s13317-017-0101-x.[4]Dawson-Hughes B (2017) Vitamin D and muscle function. J Steroid Biochem Mol Biol 173:313-6.https://doi.org/10.1016/j.jsbmb.2017.03.018.[5]Ahmed B, Nasir K, Mehmood A, Abid MA, Zehra NA, Khan AH, et al. (2021) Effect of physical activity and vitamin D compared with vitamin D alone on muscle strength, back flexibility and aerobic activity in patients with chronic kidney disease: A comparative study from Pakistan. Asia Pac J Clin Nutr 30(4):566-72.https://doi.org/10.6133/apjcn.202112_30(4).0002.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
Background This study investigated physical activity, peripheral muscle strength, exercise capacity, sleep, fatigue, anxiety and depression in patients with systemic lupus erythematosus (SLE). Material and Methods Twenty-six patients with SLE, median age 32.5 (25–43) years, and 29 healthy individuals, median age 30 (23–32) years, were included. Exercise capacity (6-minute walk test (6MWT)), peripheral muscle strength (dynamometer), physical activity (Mi Band 4 smart band), fatigue (Fatigue Severity Scale (FSS)), anxiety and depression (Hospital Anxiety Depression scale (HAD)), quality of life (SLE-specific QOL scale (SLEQoL)) and sleep (Pittsburgh Sleep Quality Index (PSQI)) were assessed. Results Demographic characteristics were similar in both groups. 6MWT distance, peripheral muscle strength, physical activity level, SLEQoL and PSQI scores were significantly lower, while FSS and HAD scores were higher in patients with SLE (p<0.05). Moreover, pre-test and post-test heart rates, dyspnea and fatigue severity scores were higher in patients with SLE than in healthy individuals (p<0.05). Conclusion Patients with SLE had lower exercise capacity, muscle strength, physical activity, quality of life and sleep quality, along with more common fatigue, anxiety and depression. Strategies need to be developed to improve these symptoms in patients with SLE for a favourable outcome.
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