Supervised physical exercise improves endothelial function in patients with systemic lupus erythematosus

Abstract

Objective: The objective of this study was to evaluate the effect of supervised physical exercise on endothelial function, ergospirometric test variables and disease activity in SLE patients.

Methods: We conducted a prospective study in which women with SLE who were available to perform physical exercise were allocated to the exercise group (EG) to practise supervised physical exercise for 1 h three times per week for 16 weeks. Those who were not available for this activity were allocated to the control group (CG). Intervention consisted of walking at a heart rate corresponding to the ventilatory 1 threshold obtained from ergospirometry and monitored by a frequency meter. At baseline (T0) and after 16 weeks (T16), patients were assessed for endothelial function by brachial artery (flow-mediated dilation), ergospirometry and disease activity (SLEDAI). Statistical analysis was performed through normality tests, Student's t-test and non-parametric tests for data with non-normal distribution. P < 0.05 was considered significant.

Results: Eighteen patients were allocated in the EG and 20 in the CG. After 16 weeks there was an increase in FMD in the EG [6.3 (6.7)% vs 14.1 (9.1)%, P = 0.006] without a change in the CG [8.4 (8.2)% vs 9.4 (5.7)%, P = 0.598]. Regarding the ergospirometric test, we found improvement in exercise tolerance [12.3 (2.4) vs 13.4 (2.6) min, P = 0.027], maximum speed [7.7 (1.0) vs 8.3 (1.2) km/h, P = 0.027] and threshold speed [5.6 (0.7) vs 6.1 (0.9) km/h, P = 0.005] in the EG without a difference in the CG. There was no difference in the SLEDAI score in both groups.

Conclusion: Physical exercise is a useful strategy to improve endothelial function and aerobic capacity without worsening disease activity in SLE patients. TRIAL REGISTRATION; ClinicalTrials.gov (http://www.clinicaltrials.gov), NCT01712529.

Keywords: endothelium; exercise; systemic lupus erythematosus.