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Exercise training in childhood-onset systemic lupus erythematosus: a controlled randomized trial
Prado DML, Benatti FB, de sa-Pinto AL, Hayashi AP, Gualano B, Pereira RMR, Sallum AME, Bonfa E, Silva CA, Roschel H
Arthritis Research & Therapy 2013 Mar 26;15(2):R46
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

INTRODUCTION: Exercise training has emerged as a promising therapeutic strategy to counteract physical dysfunction in adult systemic lupus erythematosus. However, no longitudinal studies have evaluated the effects of an exercise training program in childhood-onset systemic lupus erythematosus (C-SLE) patients. The objective was to evaluate the safety and the efficacy of a supervised aerobic training program in improving the cardiorespiratory capacity in C-SLE patients. METHODS: Nineteen physically inactive C-SLE patients were randomly assigned into two groups: trained (TR, n = 10, supervised moderate-intensity aerobic exercise program) and non-trained (NT, n = 9). Gender-, body mass index (BMI)- and age-matched healthy children were recruited as controls (C, n = 10) for baseline (PRE) measurements only. C-SLE patients were assessed at PRE and after 12 weeks of training (POST). Main measurements included exercise tolerance and cardiorespiratory measurements in response to a maximal exercise (that is, peak VO2, chronotropic reserve (CR), and the heart rate recovery (HRR) (that is, the difference between HR at peak exercise and at both the first (HRR1) and second (HRR2) minutes of recovery after exercise). RESULTS: The C-SLE NT patients did not present changes in any of the cardiorespiratory parameters at POST (p > 0.05). In contrast, the exercise training program was effective in promoting significant increases in time-to-exhaustion (p = 0.01; ES 1.07), peak speed (p = 0.01; ES 1.08), peak VO2 (p = 0.04; ES 0.86), CR (p = 0.06; ES 0.83), and in HRR1 and HRR2 (p = 0.003; ES 1.29 and p = 0.0008; ES 1.36, respectively) in the C-SLE TR when compared with the NT group. Moreover, cardiorespiratory parameters were comparable between C-SLE TR patients and C subjects after the exercise training intervention, as evidenced by the ANOVA analysis (p > 0.05, TR versus C). SLEDAI-2K scores remained stable throughout the study. CONCLUSION: A 3-month aerobic exercise training was safe and capable of ameliorating the cardiorespiratory capacity and the autonomic function in C-SLE patients. TRIAL REGISTRATION: NCT01515163.

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