Researchers from the University of Sao Paulo, Brazil, have carried out a randomised controlled trial, published in Arthritis Research and Therapy, to investigate the effects of an exercise program on patients with childhood-onset Systemic Lupus Erythematosus (C-SLE), finding it to be safe and effective at ameliorating the cardiovascular effects of the disease.
10-20 percent of patients with Systemic Lupus Erythematosus (SLE) develop their disease during childhood or adolescence. These patients with C-SLE are more likely to have a more severe disease course. Survival rates have increased among those with C-SLE but this has led to an increase in the number of patients developing long term co-morbidities, in particular cardiovascular disease.
Cardiovascular disease develops in SLE patients for a number of reasons, both due to factors related to the disease itself (such as corticosteroid use, and autonomic dysfunction), and to traditional factors that cause cardiovascular disease (such as hypertension and dyslipidemia). Previous research in adult SLE patients has shown that exercise may be a potential non-pharmacological therapy to counteract these effects, but studies have not investigated these effects in C-SLE.
In this study, by Hamilton Roschel and colleagues, patients were randomised to either participate in a 12 week supervised training program (trained group) or to remain physically inactive for the duration of the study (non-trained group). In addition an age-, gender- and BMI matched group of healthy controls were recruited. Patients in the trained group underwent a twice-weekly supervised moderate intensity exercise program which involved treadmill aerobic exercises.
C-SLE patients in both groups were assessed at baseline for clinical and laboratory parameters, cardio-respiratory response to maximal graded exercise, body composition, and bone mineral density. These assessments were repeated after the 12-week intervention. Baseline measurements were also taken from the healthy control group.
After the 12 week intervention the trained group had significant decreases in time-to-exhaustion, peak speed, and a decreased resting heart rate when compared to the non-trained group. They also had increased peak VO2, relative change in heart rate, and heart rate recovery compared to the non-trained group. At the end of the intervention, the trained group had comparable cardiorespiratory parameters to the healthy control group.
These results suggest that a supervised exercise program can be safe and effective in ameliorating the cardiovascular effects of SLE in C-SLE patients and suggest a potential role for exercise training in the management of C-SLE.
Arthritis Research & Therapy 2013, 15:R46
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