Benefits of Physical Training in Sarcoidosis

Abstract

Background Sarcoidosis patients suffer from fatigue and exercise limitation. The aim of this study was to establish whether a physical training program improves these and other outcomes important to sarcoidosis patients. Methods From 11/2012 to 9/2014, 201 sarcoidosis patients were referred to the ild care expertise team, Ede, the Netherlands. In our center, all patients are routinely recommended to undergo testing at baseline to determine their physical functioning and encouraged to complete a 12-week, supervised physical training program. Ninety patients underwent baseline testing and returned for repeat testing at 3 months in the interim, 49 completed the training program (Group I) and 41 chose not to participate (Group II). Change over time (from baseline to 3 months) in fatigue, exercise capacity, and skeletal muscle strength were assessed between the two groups.Results At baseline, there were no between-group differences for fatigue, DLCO %, FVC %, or exercise capacity [assessed by percent predicted six-minute walk distance (6MWD %) and Steep Ramp Test (SRT)]. The 6MWD for Group I improved between baseline and 3 months, while the 6MWD remained the same in Group II (F = 72.2, p \ 0.001). Group I showed a significantly larger decrease of fatigue compared with Group II (F = 6.27, p = 0.014). Lung function tests did not change in either group. Conclusion A supervised physical training program improves exercise capacity and fatigue among sarcoidosis patients and should be included in their management regimen.

Physical activity and training in sarcoidosis: review and experience-based recommendations

“…All of the sarcoidosis patients in the study by Karadalli et al had chest X-ray stage I or II [24]. In the other two studies, most patients had stage II or III (50-66%) [22,23].…”

“…Therefore, finally, only four studies were included. Average observational study quality, assessed by the STROBE checklist, was 25 out of 34 points (range [20][21][22][23][24][25][26][27][28][29][30]. The quality of the randomized trial, assessed by the PEDro scale, was 9/11, see also Table 1.…”

“…Two of the four included studies were retrospective cohort studies [21,23], one was a prospective cohort study [22], and one was a randomized controlled trial [24]. Specific information regarding patient characteristics for the sarcoidosis subpopulation in the study by Huppmann et al could not be determined from the paper or from personal correspondence with the authors [21].…”

“…The majority of patients were outpatients who performed their specific training regimen two to three times a week [22,23,29]. Patients in the study by Huppmann et al trained four to five times a week on an inpatient basis [21].…”

“…Patients in the study by Huppmann et al trained four to five times a week on an inpatient basis [21]. The interventions consisted of endurance training, peripheral muscle training [22,23,29] and inspiratory muscle training [24], exercise training, breathing training, and education [21].…”