Effects of physical activity on vascular function in autoimmune rheumatic diseases: a systematic review and meta-analysis

Abstract

Objectives To summarise existing evidence and quantify the effects of physical activity on vascular function and structure in autoimmune rheumatic diseases (ARDs). Methods Databases were searched (up to March 2020) for clinical trials evaluating the effects of physical activity interventions on markers of micro- and macrovascular function and macrovascular structure in ARDs. Studies were combined using random-effects meta-analysis, which was conducted using the Hedge's g. Meta-analyses were performed on each of the following outcomes: (1) microvascular function (i.e., skin blood flow or responses to acetylcholine [ACh] or sodium nitropusside [SNP] administration); (2) macrovascular function (i.e., brachial flow-mediated dilation [FMD%] or brachial responses to glyceryl trinitrate [GTN%]; and (3) macrovascular structure (i.e., aortic pulse wave velocity [PWV]). Results Ten studies (11 trials), with a total of 355 participants, were included in this review. Physical activity promoted significant improvements in micro- (skin blood flow responses to ACh [g = 0.92; 0.42 to 1.42]) and macrovascular function (FMD% [g = 0.94; 0.56 to 1.02]; GTN% [g = 0.53; 0.09 to 0.98]). Conversely, there was no evidence for beneficial effects of physical activity on macrovascular structure (PWV [g = -0.41; -1.13 to 0.32]). Conclusions Overall, the available clinical trials demonstrated a beneficial effect of physical activity on markers of micro- and macrovascular function, but not on macrovascular structure, in patients with ARDs. The broad beneficial impact of physical activity across the vasculature identified in this review support its role as an effective non-pharmacological management strategy for patients with ARD.

Post-COVID-19 Syndrome and the Potential Benefits of Exercise

“…Individual and targeted exercise is highly recommended as a non-pharmacologic strategy for treating rheumatic and musculoskeletal diseases, characterized by chronic pain, muscle weakness, physical limitations, fatigue and low tolerance to exercise [11,[86][87][88][89]. Besides, strength training and multicomponent exercise programs have been extensively demonstrated as safe and effective among vulnerable people in reversing frailty and weakness and restoring functional capacity in the short-and long-term [12,[90][91][92][93].…”

Association of Clinical Manifestations of Systemic Lupus Erythematosus and Complementary Therapy Use in Taiwanese Female Patients: A Cross-Sectional Study

“…The present study showed that the presence of Raynaud’s phenomenon was associated with fitness walking or strolling and fish oil supplements. Although there is no specific research that evaluates the efficacy of exercise in the treatment of Raynaud’s phenomenon, a meta-analysis of 11 trials with a total of 355 participants revealed that exercise could significantly improve microvascular and macrovascular function in patients with autoimmune diseases [ 22 ]. In the present study, we observed a significant increased use of fitness walking or strolling in our patients, as low-impact may improve blood circulation and may thereby improve Raynaud’s phenomenon.…”