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Rheumatology International

, Volume 39, Issue 2, pp 227–238 | Cite as

Supervised walking improves cardiorespiratory fitness, exercise tolerance, and fatigue in women with primary Sjögren’s syndrome: a randomized-controlled trial

  • Samira Tatiyama Miyamoto
  • Valéria Valim
  • Luciana Carletti
  • Wan-Fai Ng
  • Anselmo José Perez
  • Dennis William Lendrem
  • Michael Trennel
  • Raquel Altoé Giovelli
  • Laiza Hombre Dias
  • Érica Vieira Serrano
  • Alice Mendonça Subtil
  • Vanessa Cândido Abreu
  • Jamil NatourEmail author
Clinical Trials

Abstract

Objective

The aim of this study was to evaluate the safety and effectiveness of a supervised walking program in women with primary Sjögren’s syndrome (pSS).

Methods

Forty-five sedentary women fulfilling the American European Consensus Criteria for pSS were randomized to a training group (TG, n = 23) or control group (CG, n = 22). Patients in the TG were submitted to supervise walking three times a week for 16 weeks. The patients of the CG were instructed to not perform any kind of regular physical exercise. Physical fitness [maximum oxygen uptake (VO2max) and distance], EULAR Sjögren’s Syndrome Disease Activity Index (ESSDAI), hematological tests, and Medical Outcomes Study 36 (SF-36) were assessed at baseline and week 16. In addition, EULAR Sjögren’s Syndrome Patient Reported Index (ESSPRI), Functional Assessment of Chronic Illness Therapy Fatigue Subscale (FACIT-fatigue), and Beck Depression Inventory (BDI) were measured prior to intervention, after 8 and 16 weeks. Patient global assessment of response to therapy was completed at the final assessment. An intent-to-treat analysis was performed.

Results

After 16 weeks, the mean change of VO2max (ml/kg/min), distance, and FACIT-fatigue were higher in the TG than in the CG (p = 0.016, p = 0.043 and p = 0.030, respectively). Improved cardiorespiratory fitness was associated with improvements in fatigue scores and physical components of quality of life (SF-36). Furthermore, improved fatigue scores were associated with reduced depression and improvements in the physical and mental components of SF-36. Overall, 95.4% of patients in the TG rated themselves as clinically improved versus 62% of the patients in the CG (p = 0.049). There was no flare in disease activity and no serious adverse events with exercise.

Conclusions

This supervised walking program was demonstrated to be feasible and safe with improvements in cardiorespiratory fitness, exercise tolerance, fatigue, and patient perception of improvement in pSS patients.

Trial registration

Clinical Trials.gov ID, number NCT02370225.

Keywords

Sjögren’s syndrome Fatigue Exercise Rehabilitation 

Notes

Author contributions

Study conception and design: STM, VV, JN, LC, and AJP. Acquisition of data: RAG, LHS, EVS, VCA, and AMS. Data analysis and interpretation: STM, JN, VV, LC, AJP, DL, and WN. Writing: STM, JN, DL, and WN.

All authors have read and approved the manuscript.

Funding

This work was supported by grants to Samira Tatiyama Miyamoto from the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-CAPES Foundation [BEX 8831/14-9].

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all the participants included in the study.

Supplementary material

296_2018_4213_MOESM1_ESM.docx (19 kb)
Supplementary material 1 (DOCX 19 KB)
296_2018_4213_MOESM2_ESM.docx (21 kb)
Supplementary material 2 (DOCX 20 KB)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Integrated Education in HealthUniversidade Federal do Espírito SantoVitoriaBrazil
  2. 2.Department of RheumatologyUniversidade Federal de São Paulo-Escola Paulista de MedicinaSão PauloBrazil
  3. 3.Rheumatology Outpatient Clinic-Hospital Universitário Cassiano Antônio de Moares (HUCAM)Universidade Federal do Espírito SantoVitoriaBrazil
  4. 4.Department of Medical ClinicUniversidade Federal do Espírito SantoVitoriaBrazil
  5. 5.Exercise Physiology Laboratory (LAFEX)Universidade Federal do Espírito SantoVitoriaBrazil
  6. 6.Musculoskeletal Research Group, Institute of Cellular MedicineNewcastle UniversityNewcastle upon TyneUK
  7. 7.MoveLab, Physical Activity and Exercise Research, Institute of Cellular MedicineNewcastle UniversityNewcastle upon TyneUK

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