Open Access Open Badges Research article

Low dynamic muscle strength and its associations with fatigue, functional performance, and quality of life in premenopausal patients with systemic lupus erythematosus and low disease activity: a case–control study

Sandor Balsamo123*, Licia Maria Henrique da Mota12, Jozélio Freire de Carvalho4, Dahan da Cunha Nascimento35, Ramires Alsamir Tibana35, Frederico Santos de Santana123, Ricardo Lima Moreno6, Bruno Gualano78 and Leopoldo dos Santos-Neto12

Author Affiliations

1 Graduate Program in Medical Sciences, School of Medicine, Universidade de Brasília (UnB), Brasília, Brazil

2 Rheumatology Service, Hospital Universitário de Brasília (HUB) UnB, Brasília, Brazil

3 Physical Education Department, Centro Universitário UNIEURO, Brasília, Brazil

4 Rheumatology Division, Clínica de Oncologia (CLION), Salvador, Brazil

5 Graduate Program on Physical Education, Catholic University of Brasilia, Brasilia, Brazil

6 School of Physical Education, UnB, Brasília, Brasilia, Brazil

7 School of Physical Education and Sports, University of Sao Paulo (USP), Sao Paulo, Brazil

8 School of Medicine, Rheumatology Division, USP, Sao Paulo, Brazil

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BMC Musculoskeletal Disorders 2013, 14:263  doi:10.1186/1471-2474-14-263

Published: 8 September 2013



The purpose of the present study was to compare dynamic muscle strength, functional performance, fatigue, and quality of life in premenopausal systemic lupus erythematosus (SLE) patients with low disease activity versus matched-healthy controls and to determine the association of dynamic muscle strength with fatigue, functional performance, and quality of life in SLE patients.


We evaluated premenopausal (18–45 years) SLE patients with low disease activity (Systemic lupus erythematosus disease activity index [SLEDAI]: mean 1.5 ± 1.2). The control (n = 25) and patient (n = 25) groups were matched by age, physical characteristics, and the level of physical activities in daily life (International Physical Activity Questionnaire IPAQ). Both groups had not participated in regular exercise programs for at least six months prior to the study. Dynamic muscle strength was assessed by one-repetition maximum (1-RM) tests. Functional performance was assessed by the Timed Up and Go (TUG), in 30-s test a chair stand and arm curl using a 2-kg dumbbell and balance test, handgrip strength and a sit-and-reach flexibility test. Quality of life (SF-36) and fatigue were also measured.


The SLE patients showed significantly lower dynamic muscle strength in all exercises (leg press 25.63%, leg extension 11.19%, leg curl 15.71%, chest press 18.33%, lat pulldown 13.56%, 1-RM total load 18.12%, P < 0.001-0.02) compared to the controls. The SLE patients also had lower functional performance, greater fatigue and poorer quality of life. In addition, fatigue, SF-36 and functional performance accounted for 52% of the variance in dynamic muscle strength in the SLE patients.


Premenopausal SLE patients with low disease activity showed lower dynamic muscle strength, along with increased fatigue, reduced functional performance, and poorer quality of life when compared to matched controls.

Dynamic muscle strength; Fatigue; Quality of life; Systemic lupus erythematosus, Functional performance