Recommendations for physical activity and exercise in persons living with Systemic Lupus Erythematosus (SLE): consensus by an international task force

Julien Blaess¹, Sophie Geneton², Thibaut Goepfert^{2

3}, Simone Appenzeller⁴, Gabriel Bordier⁵, Thomas Davergne⁶, Yurilis Fuentes⁷, Håvard Haglo⁸, Karen Hambly⁹, Dominique Kinnett-Hopkins¹⁰, Kuei-Ying Su^{11

12}, Alexandra Legge^{13

14}, Linda Li^{14

15}, Anselm Mak¹⁶, Ivan Padjen^{17

18}, Savino Sciascia¹⁹, Saira Z Sheikh^{20

21}, Alberto Soriano-Maldonado²², Manuel F Ugarte-Gil²³, Md Yuzaiful Md Yusof^{24

25}, Ioannis Parodis^{26

27

28}, Laurent Arnaud²⁹

Affiliations

¹ Department of Physiology and Functional Exploration, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
² Department of Rheumatology, National Reference Center for Rare Autoimmune Diseases (RESO), Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
³ Department of Sport Medicine, Unit of Physical and Rehabilitation Medicine, University Hospital of Martinique, Fort De France, Martinique.
⁴ School of Medical Science, Universidade Estadual de Campinas (UNICAMP), Campinas, Brazil.
⁵ Service de rhumatologie, CHU d'Angers, Angers, France.
⁶ School of physiotherapy Boris Dolto, DUS2R, University of Paris Cité, Paris, France.
⁷ Departamento de Medicina, Universidad de Oriente, Ciudad Bolívar, Venezuela.
⁸ Treningsklinikken, Medical Rehabilitation Clinic, Trondheim, Norway.
⁹ School of Sport and Exercise Sciences, University of Kent, Canterbury, UK.
¹⁰ School of Kinesiology, University of Michigan, Ann Arbor, Michigan, USA.
¹¹ Division of Allergy,Immunology and Rheumatology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
¹² School of Medicine, Tzu Chi University, Hualien, Taiwan.
¹³ Division of Rheumatology, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
¹⁴ Arthritis Research Canada, Vancouver, British Columbia, Canada.
¹⁵ Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.
¹⁶ Division of Rheumatology, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
¹⁷ School of Medicine, Division of Clinical Immunology and Rheumatology, National Referral Centre for SLE and Related Disorders, University of Zagreb, Zagreb, Croatia.
¹⁸ Department of Internal Medicine, University Hospital Centre Zagreb, Zagreb, Croatia.
¹⁹ University Center of Excellence on Nephrological, Rheumatological and Rare Diseases (ERK-net, ERN-Reconnect and RITA-ERN Member) including Nephrology and Dialysis Unit and Center of Immuno-Rheumatology and Rare Diseases (CMID), Coordinating Center of the Interregional Network for Rare Diseases of Piedmont and Aosta Valley (North-West Italy), San Giovanni Bosco Hub Hospital, ASL Città di Torino and Department of Clinical and Biological Sciences of the University of Turin, Turin, Italy.
²⁰ Department of Medicine, Division of Rheumatology, Allergy & Immunology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
²¹ Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
²² Department of Education, Faculty of Education Sciences, and SPORT Research Group (CTS-1024), CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social) Research Center, University of Almería, Almería, Spain.
²³ Grupo Peruano de Estudio de Enfermedades Autoinmunes Sistémicas, Universidad Cientifica del Sur, Lima Peru and Rheumatology Department, Hospital Guillermo Almenara Irigoyen - EsSalud, Lima, Peru.
²⁴ Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.
²⁵ National Institute for Health and Care Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
²⁶ Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
²⁷ Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital, Stockholm, Sweden.
²⁸ Department of Rheumatology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
²⁹ Department of Rheumatology, National Reference Center for Rare Autoimmune Diseases (RESO), Hôpitaux Universitaires de Strasbourg, Strasbourg, France laurent.arnaud@chru-strasbourg.fr.

PMID: 38580348
PMCID: PMC11002419
DOI: 10.1136/rmdopen-2024-004171

Recommendations for physical activity and exercise in persons living with Systemic Lupus Erythematosus (SLE): consensus by an international task force

Julien Blaess et al. RMD Open. 2024.

. 2024 Apr 4;10(2):e004171.

doi: 10.1136/rmdopen-2024-004171.

Authors

Affiliations

¹ Department of Physiology and Functional Exploration, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
² Department of Rheumatology, National Reference Center for Rare Autoimmune Diseases (RESO), Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
³ Department of Sport Medicine, Unit of Physical and Rehabilitation Medicine, University Hospital of Martinique, Fort De France, Martinique.
⁴ School of Medical Science, Universidade Estadual de Campinas (UNICAMP), Campinas, Brazil.
⁵ Service de rhumatologie, CHU d'Angers, Angers, France.
⁶ School of physiotherapy Boris Dolto, DUS2R, University of Paris Cité, Paris, France.
⁷ Departamento de Medicina, Universidad de Oriente, Ciudad Bolívar, Venezuela.
⁸ Treningsklinikken, Medical Rehabilitation Clinic, Trondheim, Norway.
⁹ School of Sport and Exercise Sciences, University of Kent, Canterbury, UK.
¹⁰ School of Kinesiology, University of Michigan, Ann Arbor, Michigan, USA.
¹¹ Division of Allergy,Immunology and Rheumatology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
¹² School of Medicine, Tzu Chi University, Hualien, Taiwan.
¹³ Division of Rheumatology, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
¹⁴ Arthritis Research Canada, Vancouver, British Columbia, Canada.
¹⁵ Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.
¹⁶ Division of Rheumatology, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
¹⁷ School of Medicine, Division of Clinical Immunology and Rheumatology, National Referral Centre for SLE and Related Disorders, University of Zagreb, Zagreb, Croatia.
¹⁸ Department of Internal Medicine, University Hospital Centre Zagreb, Zagreb, Croatia.
¹⁹ University Center of Excellence on Nephrological, Rheumatological and Rare Diseases (ERK-net, ERN-Reconnect and RITA-ERN Member) including Nephrology and Dialysis Unit and Center of Immuno-Rheumatology and Rare Diseases (CMID), Coordinating Center of the Interregional Network for Rare Diseases of Piedmont and Aosta Valley (North-West Italy), San Giovanni Bosco Hub Hospital, ASL Città di Torino and Department of Clinical and Biological Sciences of the University of Turin, Turin, Italy.
²⁰ Department of Medicine, Division of Rheumatology, Allergy & Immunology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
²¹ Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
²² Department of Education, Faculty of Education Sciences, and SPORT Research Group (CTS-1024), CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social) Research Center, University of Almería, Almería, Spain.
²³ Grupo Peruano de Estudio de Enfermedades Autoinmunes Sistémicas, Universidad Cientifica del Sur, Lima Peru and Rheumatology Department, Hospital Guillermo Almenara Irigoyen - EsSalud, Lima, Peru.
²⁴ Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.
²⁵ National Institute for Health and Care Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
²⁶ Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
²⁷ Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital, Stockholm, Sweden.
²⁸ Department of Rheumatology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
²⁹ Department of Rheumatology, National Reference Center for Rare Autoimmune Diseases (RESO), Hôpitaux Universitaires de Strasbourg, Strasbourg, France laurent.arnaud@chru-strasbourg.fr.

PMID: 38580348
PMCID: PMC11002419
DOI: 10.1136/rmdopen-2024-004171

Abstract

Objective: This international task force aimed to provide healthcare professionals and persons living with systemic lupus erythematosus (SLE) with consensus-based recommendations for physical activity and exercise in SLE.

Methods: Based on evidence from a systematic literature review and expert opinion, 3 overarching principles and 15 recommendations were agreed on by Delphi consensus.

Results: The overarching principles highlight the importance of shared decision-making and the need to explain the benefits of physical activity to persons living with SLE and other healthcare providers. The 15 specific recommendations state that physical activity is generally recommended for all people with SLE, but in some instances, a medical evaluation may be needed to rule out contraindications. Pertaining to outdoor activity, photoprotection is necessary. Both aerobic and resistance training programmes are recommended, with a gradual increase in frequency and intensity, which should be adapted for each individual, and ideally supervised by qualified professionals.

Conclusion: In summary, the consensus reached by the international task force provides a valuable framework for the integration of physical activity and exercise into the management of SLE, offering a tailored evidence-based and eminence-based approach to enhance the well-being of individuals living with this challenging autoimmune condition.

Keywords: autoimmune diseases; lupus erythematosus, systemic; systemic lupus erythematosus.

PubMed Disclaimer

Conflict of interest statement

Competing interests: SG, TG, SA, GB, TD, YF, HH, KH, DK-H, K-YS, AL, LL, SS and AS-M have no disclosures. AM has received funding for an investigator-initiated study from GlaxoSmithKline (Project ID 10743). IP has received honoraria from AstraZeneca, Boehringer Ingelheim, Lilly, Novartis and Pfizer. SZS has received grant funding from Pfizer and has consulted for GlaxoSmithKline, Aurinia Pharmaceuticals Inc, AstraZeneca, Lilly, LLC, Biogen and Cabaletta. MFU-G has received funding from Janssen and honoraria from AztraZeneca, Ferrer and GlaxoSmithKline. MYMY has received consultancy fees from Aurinia Pharmaceuticals and UCB and speaker fees from Alumis, Novartis and Roche. IP has received research funding and/or honoraria from Amgen, AstraZeneca, Aurinia, Elli Lilly, Gilead, GlaxoSmithKline, Janssen, Novartis, Otsuka and Roche. LA is a consultant for Alexion, Alpine, Amgen, AstraZeneca, AbbVie, Biogen, Bristol Myers Squibb, Boehringer Ingelheim, GSK, Grifols, Janssen, LFB, Lilly, Menarini France, Medac, Novartis, Pfizer, Roche-Chugaï, Sêmeia and UCB.

References

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Recommendations for physical activity and exercise in persons living with Systemic Lupus Erythematosus (SLE): consensus by an international task force

Affiliations

Recommendations for physical activity and exercise in persons living with Systemic Lupus Erythematosus (SLE): consensus by an international task force

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical