Physical activity in patients with systemic lupus erythematosus and matched controls

Abstract

Background: As physical activity reduces cardiovascular disease (CVD) in the general population, studies concerning the frequency of physical activity in patients with systemic lupus erythematosus (SLE) are needed. Earlier studies indicate that patients with SLE are physically inactive but there are few studies that compare physical activity in SLE to that in the general population. The aim of this study was to examine different aspects of physical activity in patients with SLE and population controls and to investigate how they relate to disease activity and organ damage.

Methods: Two hundred and seventy-two patients with SLE and 272 population controls, individually matched for age, gender, and living region, were investigated clinically. For patients, the investigation included assessment of disease activity using the SLE Disease Activity Index (SLEDAI) and organ damage using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC) Damage Index. All participants filled out an extensive questionnaire concerning physical activity, exercise capacity, and sedentary behaviour.

Results: The mean age of the patients was 47 (SD 15) years. Patients reported lower (p < 0.001) capacity for walking, jogging, and running and more limiting factors for these activities than controls (p < 0.001). Patients exercised less often than controls (p < 0.01) and patients with SLICC ≥ 2 points reported less physical activity on ‘low to moderate’ intensity compared to their controls (p < 0.05). Sedentary behaviour was reported by 18% of the patients and 26% of the controls (ns).

Conclusion: Patients with SLE reported lower exercise capacity and less frequent exercise than controls. Additionally, patients with more organ damage reported less physical activity, and these, together with patients who have a sedentary behaviour, should be the focus of intervention programmes to support increased physical activity and exercise in SLE.

Acknowledgements

We would like to thank all of the participants in this study. We also thank Dr Julia Fridman Simard from the Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet for critically reviewing the manuscript and for linguistic help; Per During for statistical support, and clinical laboratory scientist Lisbet Broman, Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet for help with the figures.

This work was supported by the King Gustaf V 80th Birthday Fund, the Swedish Heart–Lung Foundation, the Swedish Rheumatism Association, the Swedish Society of Medicine, the Åke Wiberg Foundation, Alex and Eva Wallström’s Foundation, Karolinska Institutet’s Foundations, and funding through a regional agreement on medical training and clinical research (ALF) between Stockholm County Council and Karolinska Institutet and the Foundation in memory of Clas Groschinsky.