Effects of exercise on adults with systemic lupus erythematosus: a systematic review and meta-analysis

Tags: Poster
Xun Y1, Liu X2, Yang M2, Li Y2, Si W2, Chen Y1
1Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University; WHO Collaborating Centre for Guideline Implementation and Knowledge Translation; Chinese GRADE Center; Cochrane China Network, Lanzhou, 2School of Public Health, Lanzhou University, Lanzhou

Background:Systemic Lupus Erythematosus (SLE) is an autoimmune disease associated with widespread inflammation and tissue damage. Although great progress has been made in the treatment of SLE, the quality of life of SLE patients has not been effectively improved. Evidence suggests that in some cases, exercise therapy is as effective as medication, and even more effective in specific cases.

Objectives:To evaluate the effects of different exercise patterns on SLE patients.

Methods:We systematically searched PubMed, EMBASE, Cochrane library, Web of Science and China Biology Medicine disc, China National Knowledge Infrastructure, Wanfang Data from their inception to October 31, 2019. Google and Baidu academics were also searched as a compliment. After two researchers independently screened literature, extract available data and evaluate quality studies from the included studies. We only selected randomized controlled trials. We used the risk of bias (ROB) to appraise the quality of each included study. The mean differences (post-pre) with 95% confidence intervals (CIs) were used to analyze the effect size of the studies. All data were calculated by a random-effects model and the mean difference (MD) was preferred, the standardized mean difference (SMD) was used to calculate the same results measured at different scales. Statistical heterogeneity among the studies was examined with inconsistency (I2). All statistical analyses were performed with Review Manager 5.3.

Results:We included 11 Randomized controlled trials (RCTs) and 4 Quasi-randomized controlled trials (Quasi-RCTs). The results of this systematic review and meta-analysis showed that exercise is safe and feasible for SLE patients, it could effectively reduce fatigue and depression, improve quality of life, and effectively improve their cardiovascular capacity to varying degrees. Compared to sedentary, the effect of aerobic exercise were statistically significant on fatigue (MD=-0.51 and 95% CI: -0.66 to -0.37), depression (SMD=-0.56 and 95% CI: -0.88 to -0.24), gas exchange ratio of cardiovascular function (MD=0.05 and 95% CI: 0.01 to 0.09). Resistance exercise could improve patients’ quality of life in all areas (except on Vitality). Combined exercise could relieve fatigue(MD=-1.21 and 95% CI: -2.15 to -0.26), improve mental health. There was no statistical significance between aerobic exercise and resistance training in disease activity, fatigue, depression and other quality of life, cardiovascular function.

Conclusions:Although the best exercise plan has yet to be proven, according to current research, aerobic exercise whose exercise mode mainly by walking is generally recommended. Clinicians and relevant health care professionals should encourage SLE patients to change their sedentary lifestyle and start exercising.

Patient or healthcare consumer involvement: None.