Regular exercise can improve aerobic capacity, increase muscle strength and endurance, increase flexibility, maintain normal blood pressure, decrease serum cholesterol, increase caloric expenditure, enhance functional status, and improve overall quality of life. Most people benefit from physical activity and people with lupus are no different. The loss of physical conditioning can be as incapacitating as the primary symptoms of the disease. There has not been a tremendous amount of research done on this topic; however, the research that has been done points to the positive effects of physical activity on people with lupus and other conditions with symptoms similar to lupus.
Exercise training has been shown to be beneficial in rehabilitating patients with chronic conditions including cardiac diseases, hypertension, obesity, obstructive lung disease, and rheumatoid arthritis. It was originally accepted that exercise therapy in people with rheumatoid arthritis should not be vigorous, instead emphasizing rest and range-of-motion exercises. While this may be appropriate for flare-ups, recent evidence suggests that a more aggressive approach has added benefits to overall management of this condition. In a study of people with rheumatoid arthritis, the subjects answered subjective questions about their activity level and health status in initial and final evaluations. The majority of the participants reported a decreased level of pain and fatigue and increased productivity, which led to an improvement in quality of life. In addition to helping people with rheumatoid arthritis, aerobic exercise has recently been recognized as one of the mainstays of treatment in people with fibromyalgia, which is often experienced by people with lupus. A recent study found that people with fibromyalgia and connective tissue disorders reported decreased pain and some decrease in analgesic requirements as a result of exercise. These are all very positive findings on the effect of exercise on other chronic conditions.
There have also been a few studies done on the effects of exercise on people with lupus, specifically. One in particular looked at the effects of aerobic conditioning on people with lupus. It concluded that short term conditioning did not worsen joints or exacerbate the systemic disease. Another study found that in people with systemic lupus, fatigue is correlated with deconditioning, but with an 8 week supervised aerobic program, reconditioning and decreased fatigue could be achieved. Unfortunately, there is no evidence to suggest that exercise programs are being incorporated into routine practice.
While exercise programs are not always being recommended, the literature does offer some general guidelines. It is imperative that persons with lupus work closely with their physical therapists, physicians, and fitness professionals when creating an exercise routine. They should generally avoid strenuous activity if they are having a flare-up, or are in an active disease state. Finally, lower impact, moderate intensity exercises are ideal. Examples include: dancing, fast-walking, cycling, and cross-country skiing. Also, anything in the water, such as swimming or water aerobics, is beneficial because the water supports the body causing less strain on the joints.