The impact of upper limb exercise on function, daily activities and quality of life in systemic lupus erythematosus: a pilot randomised controlled trial

Abstract

ObjectiveTo assess the effect of upper limb exercise on hand function, daily activities performance and quality of life of patients with systemic lupus erythematosus (SLE).MethodsWe performed a pilot randomised, 24-week follow-up, unmasked controlled trial. Inclusion criteria were upper limb arthralgias, a Disabilities of Arm, Shoulder and Hand (DASH) questionnaire score >10 and a stable treatment over the past 3 months. Patients were randomly allocated in the routine care (control) or exercise group that received an individually tailored 30-min daily upper-limb exercise programme by a hand therapist for 12 weeks. We evaluated at 0, 6, 12 and 24 weeks the performance of daily activities for both groups with DASH questionnaire and Health Assessment Questionnaire (HAQ), the grip and pinch strength with Jamar dynamometer and pinch gauge tool, respectively, the dexterity with Purdue pegboard test, the quality of life with Lupus Quality of Life (LupusQoL) Questionnaire and the pain level by Visual Analogue Scale (VAS) score.ResultsFrom 293 consecutive SLE patients, data from 32 patients allocated to the exercise group and 30 to the control group were analysed. There was a significant difference between the two groups in percentage changes of DASH, HAQ, grip strength, pinch strength, LupusQoL-physical health and fatigue, and VAS scores from baseline to 6, 12 and 24 weeks, and from baseline to 12 weeks for dexterity test (p<0.001). No interaction was observed between exercise and disease activity or medication use at baseline and during the observation period.ConclusionUpper-limb exercise significantly improves hand function, pain, daily activity performance and quality of life in SLE.Trial registration numberNCT03802578.

Efficacy of high-intensity laser therapy on arthropathy of the hands in patients with systemic lupus erythematosus: a double-blinded, randomized controlled trial

“…The results of the current studies were in agreement with other studies that reported significant improvement in handgrip strength, pinch strength, dexterity and quality of life, and a significant decrease of pain in the exercise group. 21,[42][43][44] In contrast, other studies did not report pain reduction post-exercise, 45,46 it is probably due to the use different types of the exercises. The exercises in the current study were safe, welltolerated and improved function which were in line with other studies.…”

“…The exercises in the current study were safe, welltolerated and improved function which were in line with other studies. 21,47 Only female subjects were included in this study for some reasons. Female subjects have greater rates of incidence than male subjects with ratio ranges from 10:1 to 15:1 during reproductive years due to the effects of estrogens and androgens hormones.…”

“…Strengthening exercises were in the form of isometric exercise for hand muscles and fingers to maintain muscles strength, and joints flexibility. 20,21 Patients in the study group received high-intensity laser therapy with neodymium-yttrium aluminum garnet (Nd:YAG) laser, produced by a HIRO 3 device (ASA Laser, Arcugnano, Italy) three sessions per week, over eight successive weeks. The device is equipped with a standard handpiece endowed with a fixed spacer and has a diameter of 0.5 cm and a spot size of 0.2 cm 2 .…”

Health‐Related Quality of Life Measures in Adult Systemic Lupus Erythematosus

“…Translations are available in numerous languages, making the instrument accessible for use in clinical practice, although psychometric evaluations of most of the translations have not yet been published. Despite inconsistent reports of responsiveness in validation studies of the LupusQoL, two domains of the instrument were responsive to the intervention in a clinical trial setting . Future studies examining the responsiveness of the LupusQoL will elucidate its role in treatment studies of SLE.…”

“…Two RCTs using the scale were identified ; however, only one has published results . The LupusQoL was responsive to the intervention longitudinally, reflecting improvements in the physical health and fatigue domains over time, compared with the control arm.…”