Exercise for people with systemic sclerosis or systemic lupus erythematosus

Exercise for people with systemic sclerosis or systemic lupus erythematosus

Aims: The aim of this research was to identify the effectiveness and experience of exercise in adults with systemic lupus erythematosus (SLE) and systemic sclerosis (SSc).

Methods: Study 1 is a systematic review on the effectiveness of exercise as adjunct therapy in SLE. Study 2 is a systematic review protocol on exercise and physical therapy in SSc and is ongoing. Study 3 is a qualitative interview study exploring rheumatology practitioners’ perspectives of exercise in SLE and SSc. Study 4 is a qualitative focus group study exploring the perspectives of exercise in SSc. Study 5 is a mixed method non-randomised controlled pilot trial exploring the effectiveness of telehealth-supervised exercise in SLE.

Results. Exercise is undoubtedly a highly valued intervention by rheumatologists, rheumatology nurses, and people living with SLE and SSc, with several measured and perceived benefits and barriers to exercise. Overall, exercise is ‘safe’, with no reported adverse effects, and is effective in reducing levels of fatigue and depression and improving physical fitness and physical functioning in people with SLE, and has the potential to improve aerobic capacity, exercise tolerance, muscular endurance, fatigue, pain, and life satisfaction in people with SSc. Rheumatology practitioners describe exercise to be beneficial for people with SLE and SSc with few concerns about its safety, admittedly lack time and confidence to prescribe specific exercise for their patients, and importantly, recommend long-term and supervised exercise for this population. People with SSc also describe several benefits to exercise, address disease-related barriers to engaging in exercise, and raise the importance of modified supervised exercise. Key findings from our mixed-method investigation suggest that telehealth-supervised exercise was feasible for, and well-accepted by, adults with SLE, and resulted in some modest health improvements. Importantly, participants described telehealth-supervised exercise as efficient, despite some challenges of exercising from home (such as limited equipment and space), were satisfied by the experience, and would engage in telehealth-supervised again.

Conclusion: This thesis provides researchers, exercise professionals, rheumatology practitioners, and people with SLE and SSc, with a more comprehensive understanding about the beneficial effects of exercise and highlights some opportunities for further research.

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