High-intensity interval and resistance training programme improves pain and fatigue outcomes in people with systemic sclerosis: a European multicentre randomised controlled trial
RMD Open, vol. 11, pp. e005946
Abstract
BACKGROUND: Pain and fatigue are among the most debilitating symptoms of systemic sclerosis (SSc), severely impairing quality of life (QoL). Pharmacological management is often inadequate, and evidence on exercise is limited. This study aimed to evaluate the effects of a tailored exercise programme on pain and fatigue in people with SSc (PwSSc). METHODS: This European multicentre randomised controlled trial (n=6) recruited 170 PwSSc (89% limited cutaneous SSc), randomised to an exercise intervention group (EIG) or usual care group (UCG). The EIG completed a 12-week, twice-weekly supervised programme combining 30 min of high-intensity interval training (HIIT) and 15 min of resistance training (RT), in addition to usual care. The UCG received usual care alone. Outcomes were assessed at baseline, 12 weeks (primary endpoint) and 24 weeks, with pain and fatigue as primary outcomes, and QoL, depression, functional ability, musculoskeletal strength/endurance and cardiorespiratory fitness as secondary outcomes. RESULTS: At 12 weeks, the mean group differences for the primary, fatigue (-10.4 (95% CI 19.4 to -1.4), p<0.05) and pain (0.48 (95% CI 0.21 to 0.76), p<0.05), secondary, depression (p<0.001), QoL and self-reported function (p<0.05) and exploratory outcomes musculoskeletal strength and endurance (p<0.01), and cardiorespiratory fitness (p<0.001) were significantly improved in EIG compared with UCG. CONCLUSIONS: A 12-week supervised combined upper body exercise programme can improve pain, fatigue, depression, QoL, function, strength and cardiorespiratory fitness in PwSSc. HIIT combined with RT is safe for the study population and may serve as an effective non-pharmacological adjunct to pharmacotherapy to manage SSc symptoms and enhance QoL. TRIAL REGISTRATION NUMBER: NCT05234671.
Authors 13
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Affiliation as printed
Lifestyle Exercise and Nutritional Improvement (LENI) Research Group, Centre for Applied Health & Social Care Research (CARe), Sheffield Hallam University, Sheffield, UK
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University of Copenhagen · Copenhagen University Hospital · Rigshospitalet
Affiliation as printed
Copenhagen Research Centre for Autoimmune Connective Tissue Diseases, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
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Aristotle University of Thessaloniki
Affiliation as printed
Laboratory of Sports Medicine, Department of Physical Education and Sports Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Affiliation as printed
Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
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University of Campania "Luigi Vanvitelli"
Affiliation as printed
Department of Precision Medicine, Universita degli Studi della Campania Luigi Vanvitelli, Naples, Italy
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University of Copenhagen · Copenhagen University Hospital · Rigshospitalet
Affiliation as printed
Copenhagen Research Centre for Autoimmune Connective Tissue Diseases, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
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Karolinska Institutet · Sunderby sjukhus
Affiliation as printed
Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
Department of Physiotherapy, Sunderby Hospital, Luleå, Sweden
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Leiden University Medical Center
Affiliation as printed
Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
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Leiden University Medical Center
Affiliation as printed
Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
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Aristotle University of Thessaloniki · Ippokrateio General Hospital of Thessaloniki
Affiliation as printed
4th Department of Internal Medicine, School of Medicine, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
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Royal Hallamshire Hospital · Sheffield Teaching Hospitals NHS Foundation Trust
Affiliation as printed
Department of Rheumatology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
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University of Copenhagen · Copenhagen University Hospital · Rigshospitalet
Affiliation as printed
Copenhagen Research Centre for Autoimmune Connective Tissue Diseases, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
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Affiliation as printed
Lifestyle Exercise and Nutritional Improvement (LENI) Research Group, Centre for Applied Health & Social Care Research (CARe), Sheffield Hallam University, Sheffield, UK
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