Muscle Strength in Lupus Patients, Gained Through Walking and Other Exercise, Seen as Key to Avoiding Disability

How often should you exercise when you have lupus? Research has shown that lupus patients are strong believers in the benefits of exercise, but may not exercise enough over concerns of fatigue, overexposure to sunlight, and injury — legitimate concerns but ones less important than countering the disease’s impact on muscular weakness and pain though regular exercise. A lack of activity, research has also shown, often leads to severe disability in lupus patients.

A study investigated the link between muscle strength and physical disability in 146 women with lupus, and found a key and positive correlation between leg strength and disability. Led by researchers at the University of California, San Francisco (UCSF), and the Veterans Affairs Medical Center in San Francisco, the study was titled “Muscle Strength, Muscle Mass, and Physical Disability in Women with Systemic Lupus Erythematosus” and published in Arthritis Care & Research.

James S. Andrews, MD, Patricia P. Katz, PhD and colleagues measured the women’s leg muscle strength through knee extension and flexibility exercises, and chair-stand time — the time it takes to stand up from a standard chair without using the arms, sit down again, and repeat the routine five times. They also asked participants to assess their level of disability, and list their ability or inability to perform activities important in their daily routines.

Using these tests, they were able to correlate muscle strength (the ability to perform tasks), muscle mass (how much muscle exists), and disability scores. They found that the lower a woman’s leg strength is, the more physical disability she reported — regardless of factors that included disease activity, depression or muscle mass. “While this trend has been seen in other groups, like the elderly, this is the first time it has shown this to be the case for a larger group of individuals with lupus,” Dr. Andrews said in a press release. “It makes sense that the more muscle mass you have, the stronger you are and the less disabled you are, but the really exciting finding was that a woman’s muscle strength has a bigger impact on her physical performance than her overall muscle mass does.”

The findings suggest that if healthcare providers could improve a woman’s strength, they could help to ease or prevent her physical disability. “Physical functioning is a major determinant of health-related quality of life. Thus, if we improve physical functioning, we can make an impact on overall quality of life for women with lupus,” Dr. Andrews said.

“Physical activity — such as walking, swimming, cycling — will improve cardiovascular health as well as muscle strength. This is an important benefit for people with lupus because their risk of having heart problems is higher than the general population,” Dr. Katz said. “Physical activity is also effective in helping mood. It’s even recommended by the American Psychiatric Association as a first-line treatment for people with lower levels of depression. Increasing physical activity also appears to have benefits in reducing fatigue and improving sleep.”

The co-authors noted that walking is a simple way to improve physical activity levels, and could be encouraged through the use of pedometers or activity monitors available for smartphones. “Something as simple as walking most days of the week for 15–20 minutes can have a major impact, not only in preserving physical function, but also in improving overall health,” Dr. Andrews concluded.