Physical activity but not sedentary activity is reduced in primary Sjögren’s syndrome

Abstract

The aim of the study was to evaluate the levels of physical activity in individuals with primary Sjögren’s syndrome (PSS) and its relationship to the clinical features of PSS. To this cross-sectional study, self-reported levels of physical activity from 273 PSS patients were measured using the International Physical Activity Questionnaire-short form (IPAQ-SF) and were compared with healthy controls matched for age, sex and body mass index. Fatigue and other clinical aspects of PSS including disease status, dryness, daytime sleepiness, dysautonomia, anxiety and depression were assessed using validated tools. Individuals with PSS had significantly reduced levels of physical activity [median (interquartile range, IQR) 1572 (594–3158) versus 3708 (1732–8255) metabolic equivalent of task (MET) × min/week, p < 0.001], but similar levels of sedentary activity [median (IQR) min 300 (135–375) versus 343 (223–433) (MET) × min/week, p = 0.532] compared to healthy individuals. Differences in physical activity between PSS and controls increased at moderate [median (IQR) 0 (0–480) versus 1560 (570–3900) MET × min/week, p < 0.001] and vigorous intensities [median (IQR) 0 (0–480) versus 480 (0–1920) MET × min/week, p < 0.001]. Correlation analysis revealed a significant association between physical activity and fatigue, orthostatic intolerance, depressive symptoms and quality of life. Sedentary activity did not correlate with fatigue. Stepwise linear regression analysis identified symptoms of depression and daytime sleepiness as independent predictors of levels of physical activity. Physical activity is reduced in people with PSS and is associated with symptoms of depression and daytime sleepiness. Sedentary activity is not increased in PSS. Clinical care teams should explore the clinical utility of targeting low levels of physical activity in PSS.Electronic supplementary materialThe online version of this article (doi:10.1007/s00296-016-3637-6) contains supplementary material, which is available to authorized users.

Understanding Fatigue in Sjögren’s Syndrome: Outcome Measures, Biomarkers and Possible Interventions

“…All the MFI-20 subscales and the fatigue VAS improved from baseline, but with negligible differences between the two treatments. Similar to earlier results using pharmacologic doses, substitution treatment in DHEA-deficient and severely fatigued patients with pSS was not better than placebo (39).…”

“…Different non-pharmacological interventions for fatigue have been investigated in other rheumatic diseases (53), and selfmanagement training through patient education programs, cognitive-behavioral therapy, and mindfulness could also be tested in pSS. The positive effect of placebo observed in therapeutic clinical studies (38,39) does indeed give promise for cognitive behavioral interventions. Ongoing studies investigating treatment of SS with fatigue as the primary outcomes are listed in Table 2 and include biological agents as well as alternative treatments such as dietary supplements and acupuncture.…”

The Effectiveness and Safety of Total Glucosides of Paeony in Primary Sjögren's Syndrome: A Systematic Review and Meta-Analysis

“…According to latest epidemiological data, the prevalence of pSS is about 0.29 to 0.77% in China (Chinese Rheumatology Association, 2010), and the incidence and prevalence rates global wide are 6.92 (95% CI 4.98 to 8.86) per 100,000 persons and 60.82 (95% CI 43.69 to 77.94) per 100,000 persons, respectively (Qin et al, 2015). Key symptoms such as glandular features, musculoskeletal pain, and fatigue can result in harsh physical limitations, immense psychological distress, and severe complications such as lymphoma, even greater financial burdens on patients' family in long term, which has been considerably affecting their quality of life, making it a heated research focus for medical specialists worldwide (Lackner et al, 2017; Ng et al, 2017; Stack et al, 2017; Alunno et al, 2018).…”

<p>Managing fatigue in patients with primary Sj&ouml;gren&rsquo;s syndrome: challenges and solutions</p>

“…Fatigue is known to be associated with lower aerobic capacity16 and lower physical activity levels 17,18. Wouters et al have shown that pSS patients with lower physical activity, higher activity avoidance, and greater somatic focus have more severe symptoms of fatigue 19.…”