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

Strookappe, Bert; Saketkoo, Lesley Ann; Elfferich, Marjon; Holland, Anne E; Vries, Jolanda De; Knevel, Ton; Drent, Marjolein

doi:10.1080/17476348.2016.1227244

Cited by 32 publications

(39 citation statements)

References 67 publications

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“…Current papers recommend PR for sarcoidosis patients [19], particularly those with muscle weakness. The goal of this study is to assess and discuss the short-term changes in pulmonary and QoL parameters in patients with sarcoidosis undergoing a multimodal and interdisciplinary PR.…”

Section: Introductionmentioning

confidence: 99%

Short-Term Effects of a Multimodal 3-Week Inpatient Pulmonary Rehabilitation Programme for Patients with Sarcoidosis: The ProKaSaRe Study

Lingner

Buhr-Schinner²,

Hummel

et al. 2018

Respiration

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Background: Real-world data on the effects of a multicomponent pulmonary rehabilitation (PR) for patients with sarcoidosis are scarce. Objective: To describe characteristics of patients with sarcoidosis referred for a 3-week inpatient PR, to assess the effects of PR on their quality of life (QoL) and clinical outcomes, and to investigate whether there are specific subgroups who particularly benefit from PR. Methods: Using a prospective multicentre study design, data regarding 6-min walking distance (6MWD), QoL (Saint George’s Respiratory Questionnaire, SGRQ), and the secondary outcomes of dyspnoea and psychological burden (fatigue, anxiety, and depression) were collected. Results: We included 296 patients in the study (average age 49.1 ± 9.7 years, 47% female, average vital capacity 3.5 ± 1.0 L [87.0 ± 20.6 predicted]). The 6MWD improved by the end of the rehabilitation by 39.8 m on average (p < 0.0001; standardised response mean, SRM = 0.61), SGRQ showed significant improvements in all 3 domains, and the total score (p < 0.001) improved by 5.69–8.28 points (SRM 0.46–0.62). For the secondary outcomes, significant improvement (p < 0.001) was seen for all measured parameters, e.g., dyspnoea (modified Medical Research Council Scale, mMRC), fatigue (Fatigue Assessment Scale [FAS]; SRM = –0.71), anxiety and depression (Hospital Anxiety and Depression Scale [HADS]; SRM –0.58/–0.38), and generic QoL (measured by the SF-36 scales of physical and mental health; SRM 0.31/0.55). Conclusions: Our results provide the first documented evidence that PR is a promising complementary therapy option for sarcoidosis patients who remain subjectively symptomatic despite optimised outpatient medical treatment.

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Section: Introductionmentioning

confidence: 99%

Short-Term Effects of a Multimodal 3-Week Inpatient Pulmonary Rehabilitation Programme for Patients with Sarcoidosis: The ProKaSaRe Study

Lingner

Buhr-Schinner²,

Hummel

et al. 2018

Respiration

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“…One study using a similar 5RM protocol showed significantly improvements in maximal muscle strength after 8 weeks in patients with COPD [31]. Although this study was not designed to measure effects on maximal muscle strength, the absence of adverse events and the non-aggravation of fatigue following our high-intensity RT protocol, might be a step towards defining the most optimal RT program for sarcoidosis patients [32].…”

Section: Discussionmentioning

confidence: 99%

The acute effects of resistance training on fatigue in patients with pulmonary sarcoidosis

Grongstad¹,

Vøllestad

Oldervoll

et al. 2019

Preprint

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Introduction: Sarcoidosis-related fatigue and skeletal muscle dysfunction are frequent symptoms in patients with sarcoidosis. Despite lacking knowledge whether high-intensity resistance training (RT) will worsen fatigue, low to moderate intensity is commonly recommended. This study aimed to investigate whether a single session of high-intensity RT will induce a larger acute increase in fatigue than a single RT session of moderate-intensity. Methods: In this crossover study, 41 patients with pulmonary sarcoidosis (age: 53 ± 11 yr) were recruited. They randomly performed one session of high-intensity, 4 sets x 5 repetitions maximum (5RM), and one session of moderate-intensity, 2 sets x 25 RM. Fatigue was assessed with the Visual Analogue Scale (0-100 mm) before (T0), immediately after (T1) and 24 hours after (T2) each exercise session. Results: Fatigue development from T0 to T1 was significantly lower after 5RM (– 3 ± 18 mm) than after 25RM (5 ± 15 mm), p = 0.004. No difference was seen from T0 to T2 between 5RM (0 ± 17 mm) and 25RM (6 ± 18 mm), p = 0.147. Conclusion: Since the 5RM session did not induce a larger increase in fatigue than the 25RM session, a single session of RT thus appears feasible and safe in patients with pulmonary sarcoidosis irrespective of the RT intensity. The long-term effects of high-intensity RT on fatigue should be explored in a RT program of longer duration.

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“…45,46 In sarcoidosis, non-organ-specific manifestations, such as fatigue, cognitive dysfunction, SFN-associated symptoms, depressed mood, and anxiety can be enigmatic resulting from myriad causes possibly stemming from systemic inflammation, cardiopulmonary compromise, pain, hypothalamic dysfunction, central nervous system (CNS) or PNS abnormalities as well as sleep quality, medication effects, or decreased exercise. 47 Non-organ-specific symptoms predict fatigue with cognitive dysfunction or depressed mood predicting high fatigue levels. 48…”

Section: Fatigue and Cognitive Dysfunctionmentioning

confidence: 99%

“…112 Several studies demonstrate short-term benefits of physical therapy and exercise training in reducing fatigue and improving exercise capacity. 47,110,113,114 Long-term benefits of this intervention as well as patient-directed continuation of exercise should be investigated in larger randomized controlled studies.…”

Section: Fatigue and Cognitive Dysfunctionmentioning

confidence: 99%

The Burden of Neurosarcoidosis: Essential Approaches to Early Diagnosis and Treatment

Voortman

Stern

Saketkoo

et al. 2020

Semin Respir Crit Care Med

Self Cite

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Neurosarcoidosis (NS) is an often severe, destructive manifestation with a likely under-reported prevalence of 5 to 15% of sarcoidosis cases, and in its active phase demands timely treatment intervention. Clinical signs and symptoms of NS are variable and wide-ranging, depending on anatomical involvement. Cranial nerve dysfunction, cerebrospinal parenchymal disease, aseptic meningitis, and leptomeningeal disease are the most commonly recognized manifestations. However, non-organ-specific potentially neurologically driven symptoms, such as fatigue, cognitive dysfunction, and small fiber neuropathy, appear frequently.Heterogeneous clinical presentations and absence of any single conclusive test or biomarker render NS, and sarcoidosis itself, a challenging definitive diagnosis. Clinical suspicion of NS warrants a thorough systemic and neurologic evaluation hopefully resulting in supportive extraneural physical exam and/or tissue findings. Treatment targets the severity of the manifestation, with careful discernment of whether NS reflects active potentially reversible inflammatory granulomatous disease versus inactive postinflammatory damage whereby functional impairment is unlikely to be pharmacologically responsive. Non-organ-specific symptoms are poorly understood, challenging in deciphering reversibility and often identified too late to respond to conventional immunosuppressive/pharmacological treatment. Physical therapy, coping strategies, and stress reduction may benefit patients with all disease activity levels of NS.This publication provides an approach to screening, diagnosis, disease activity discernment, and pharmacological as well as nonpharmacological treatment interventions to reduce disability and protect health-related quality of life in NS.

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

Cited by 32 publications

References 67 publications

Short-Term Effects of a Multimodal 3-Week Inpatient Pulmonary Rehabilitation Programme for Patients with Sarcoidosis: The ProKaSaRe Study

Short-Term Effects of a Multimodal 3-Week Inpatient Pulmonary Rehabilitation Programme for Patients with Sarcoidosis: The ProKaSaRe Study

The acute effects of resistance training on fatigue in patients with pulmonary sarcoidosis

The Burden of Neurosarcoidosis: Essential Approaches to Early Diagnosis and Treatment

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