Perceptions and measurements of physical activity in patients with systemic lupus erythematosus

Abstract

Promoting physical activity should be a priority for patients with systemic lupus erythematosus (SLE) because a sedentary lifestyle compounds patients' already disproportionately high risk for cardiovascular events and other adverse health outcomes. The objectives of this pilot study were to assess physical activity in 50 patients with SLE and to compare activity levels with clinical and psychosocial variables, such as fatigue, depressive symptoms, and social support and stress. Patients were asked open-ended questions about physical activity, and responses were coded according to Grounded Theory. Patients then completed the Paffenbarger Physical Activity and Exercise Index, a survey of lifestyle energy expenditure reported in kilocalories/week, performed a 2-minute walk test according to a standard protocol, and completed questionnaires measuring fatigue, depressive symptoms and social support and stress. Most patients (92%) were women, had a mean age of 45 years, and did not have extensive SLE. In response to open-ended questions, patients reported they avoided physical activity because they did not want to exacerbate SLE in the short term. However, if they could overcome initial hurdles, 46 patients (92%) thought physical activity ultimately would improve SLE symptoms. Walking was the preferred activity and 45 (90%) thought they could walk more. According to the Paffenbarger Index, mean energy expenditure was 1466 ± 1366 kilocalories/week and mean time spent in moderate-intensity activity was 132 ± 222 min/week. In total, 18 patients (36%) and 14 patients (28%) met physical activity goals for these values, respectively. Mean distance walked during the 2-minute test was 149 ± 28 m, equivalent to two blocks, which is similar to reports for stable patients with other chronic diseases. Patients with more social stress and more fatigue reported less physical activity. We conclude that the proportion of patients meeting physical activity goals was low; however, patients performed well on a standard walking test. Most patients believed physical activity provided long-term benefits for SLE and that they could be more physically active.

Why are kids with lupus at an increased risk of cardiovascular disease?

“…The same group used the American Thoracic Society protocol [79] to show a significant reduction in the distance walked on the 6-min walk test compared to controls and that SLE patients had lower dynamic muscle strength, lower functional performance and greater fatigue than controls [80,81]. Mancuso et al [82] examined 50 adults with SLE and showed that SLE patients who thought that they should be more active walked shorter distances in 2 min than those who did not (145±25 m vs. 170±39 m) and that patients with more social stress and fatigue reported less physical activity.…”

Physical Activity Program Is Helpful for Improving Quality of Life in Patients with Systemic Lupus Erythematosus

“…Previous studies have shown that these patients have lower physical capacity, increased fatigue and poorer quality of life compared to healthy population (Krupp et al 1990;Wekking 1993;Dobkin et al 1999;Bruce et al 1999;Iverson et al 2001;Stoll et al 2001;Tench et al 2002Tench et al , 2003Jolly 2005;Stojanovich et al 2007), each of which is a possible consequence of fatigue, depressed behavior, obesity and association with other autoimmune diseases, such as fibromyalgia, diabetes, and thyroid function disorder (Petri et al 1992;Svenungsson et al 2001;Bruce et al 2003;Oeser et al 2005;Urowitz et al 2008;Goldberg et al 2009). According to current literature, patients with SLE may benefit from exercise through prevention of cardiovascular and cerebrovascular diseases (Cronin 1988;Ayan and Martin 2007;Mancuso et al 2011). Exercise increases plasma levels of high-density lipoprotein cholesterol and reduces triglyceride levels, thereby preventing the occurrence of hypercholesterolemia, which is an important factor in the development of atherosclerosis (Urowitz et al 2008;Volkmann et al 2010).…”

Exercise as an anti-inflammatory therapy for rheumatic diseases—myokine regulation

“…Epidemiological evidence from patients with rheumatic diseases shows that chronic systemic inflammation might account for the substantially increased cardio vascular risk 2 and associated comorbidities of muscle wasting, anaemia, insulin resistance, dyslipidaemia and accelerated atherosclerosis, [3][4][5][6][7][8] negatively affecting the ability of patients to engage in physical activity. [9][10][11] These comorbidities, along with decreased physical activity, might contribute to inflammation, establishing a 'vicious cycle' of chronic inflammation in patients with inflammatory rheumatic diseases.…”