Physical training in sarcoidosis

Marcellis, Rik; Veeke, M.A.F. Van der; Mesters, Ilse; Drent, Marjolein; Bie, Rob A. de; Vries, Geeuwke J. de; Lenssen, Antoine F.

doi:10.1016/j.physio.2015.03.1803

Cited by 23 publications

(76 citation statements)

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“…Dyspnea is an indicator of the severity of sarcoidosis [29] , and a high MRC grade is interpreted as an expression of a stronger impairment of the patient. Then again, fatigue and dyspnea were reduced by a physical training program for 13 weeks [30] . Cavalcante et al [31] found in chronic obstructive pulmonary disease patients that a high degree of dyspnea on the MRC scale was an independent risk factor for poor subjective sleep quality on the Pittsburgh Sleep Quality Index (PSQI) and was, at the same time, positively correlated with the severity of fatigue.…”

Section: Discussionmentioning

confidence: 99%

Fatigue and Excessive Daytime Sleepiness in Sarcoidosis: Prevalence, Predictors, and Relationships between the Two Symptoms

et al. 2017

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Background: Fatigue is common among patients with sarcoidosis. The etiology of this problem is unknown and multifactorial. Fatigue can be confounded with excessive daytime sleepiness (EDS). Fatigue and sleepiness have rarely been studied simultaneously in sarcoidosis patients. Objectives: The aim of this study was the confounder-adjusted estimation of risks for severe fatigue and EDS in a large population of sarcoidosis patients and the development of multivariate predictors from this population. Methods: 1,197 German sarcoidosis patients were examined using the Epworth Sleepiness Scale (ESS), the Fatigue Assessment Scale (FAS), the Hospital Anxiety and Depression Scale (HADS), and the Medical Research Council (MRC) dyspnea scale. Results: 16.5% (123 patients) had EDS (ESS ≥16), 16.4% had severe fatigue (FAS ≥35), and 6.3% had both extreme findings. In a multivariate logistic regression model, predictors of the risk of EDS were a history of sleep apnea (odds ratio [OR] 2.46, 95% confidence interval [CI] 1.5-3.9), dyspnea MRC grade ≥2 (OR 2.29, 95% CI 1.5-3.5), and organ involvement of 4-7 organs (OR 1.60, 95% CI 1.1-2.4). Significantly associated with higher risk of severe fatigue were the following: conspicuous depression (OR 5.95, 95% CI 4.1-8.7), conspicuous anxiety (OR 2.38, 95% CI 1.6-3.4), and muscle pain (OR 1.92, 95% CI 1.32-2.75). The logit models for severe fatigue with and without simultaneous EDS differed only slightly. Conclusion: An extreme form of fatigue and/or sleepiness was found in 27% of all sarcoidosis patients questioned. Because there is a certain overlap, both should be examined simultaneously to allow for a combined assessment.

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Section: Discussionmentioning

confidence: 99%

Fatigue and Excessive Daytime Sleepiness in Sarcoidosis: Prevalence, Predictors, and Relationships between the Two Symptoms

et al. 2017

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“…3 Change of the sixminute walking distance (meters) between baseline and after 3 months follow-up: Group I: followed a supervised physical training program; Group II: no training Exercise programs and pulmonary rehabilitation are beneficial for patients with many respiratory diseases [12], and evidence on the benefits of pulmonary rehabilitation (PR) and exercise for sarcoidosis patients is increasing [13,18,[34][35][36]. Our study builds on the results of a study by Marcellis et al who observed that fatigue declined and 6MWD and peripheral muscle strength improved after a 13-week physical training program in sarcoidosis patients [13]. Ryerson and his colleagues found that PR improved exercise capacity in interstitial lung disease (ILD) patients, regardless of baseline 6MWD, and patients with worse baseline functional capacity had greater improvements following PR [37].…”

Section: Discussionmentioning

confidence: 99%

“…In several chronic-including lung-diseases, physical training has been shown to improve exercise intolerance and peripheral muscle weakness [12,13]. Limited data suggest that pulmonary rehabilitation-the backbone of which is an exercise program that most often includes a combination of aerobic and resistance training-or an exercise training program that runs outside the confines of a formal pulmonary rehabilitation program is a safe intervention [14][15][16][17] that improves symptoms, physical functioning, and QoL in these patients [12,14].…”

Section: Introductionmentioning

confidence: 99%

“…Limited data suggest that pulmonary rehabilitation-the backbone of which is an exercise program that most often includes a combination of aerobic and resistance training-or an exercise training program that runs outside the confines of a formal pulmonary rehabilitation program is a safe intervention [14][15][16][17] that improves symptoms, physical functioning, and QoL in these patients [12,14]. Recently, Marcellis and colleagues observed that in sarcoidosis patients, fatigue, physical functioning, and psychological health all improved in response to physical training [13]. Our group showed that a 12-week physical training program improved or maintained exercise capacity in patients with severe fibrotic sarcoidosis or progressive idiopathic pulmonary fibrosis [18].…”

Section: Introductionmentioning

confidence: 99%

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Benefits of Physical Training in Sarcoidosis

Strookappe

Swigris

Vries

et al. 2015

Lung

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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.

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“…28,60,[62][63][64] Because the patients' ability to handle physical activity is clearly decreased, however, the activities should be adjusted, and rehabilitation programs should be designed carefully. 61,69,70 Overall Impact on Patients' Lives: Quality of Life…”

Section: Physical Impairmentmentioning

confidence: 99%