title: Using exercise training to counterbalance chronotropic incompetence and delayed heart rate recovery in systemic lupus erythematosus: a randomized trial.
abstract: OBJECTIVE
  To evaluate the efficacy of a 3-month exercise training program in counteracting the chronotropic incompetence and delayed heart rate recovery in patients with systemic lupus erythematosus (SLE).
  
  
  METHODS
  A 12-week randomized trial was conducted. Twenty-four inactive SLE patients were randomly assigned into 2 groups: trained (T; n = 15, 3-month exercise program) and nontrained (NT; n = 13). A sex-, body mass index-, and age-matched healthy control (C) group (n = 8) also underwent the exercise program. Subjects were assessed at baseline and at 12 weeks after training. Main measurements included the chronotropic reserve (CR) and the heart rate (HR) recovery (ΔHRR) as defined by the difference between HR at peak exercise and at both the first (ΔHRR1) and second (ΔHRR2) minutes after the exercise test.
  
  
  RESULTS
  Neither the NT SLE patients nor the C group presented any change in the CR or in ΔHRR1 and ΔHRR2 (P > 0.05). The exercise training program was effective in promoting significant increases in CR (P = 0.007, effect size [ES] 1.15) and in ΔHRR1 and ΔHRR2 (P = 0.009, ES 1.12 and P = 0.002, ES 1.11, respectively) in the SLE T group when compared with the NT group. Moreover, the HR response in SLE patients after training achieved parameters comparable to the C group, as evidenced by the analysis of variance and by the Z score analysis (P > 0.05, T versus C). Systemic Lupus Erythematosus Disease Activity Index scores remained stable throughout the study.
  
  
  CONCLUSIONS
  A 3-month exercise training program was safe and capable of reducing the chronotropic incompetence and the delayed ΔHRR observed in physically inactive SLE patients.
authors.affiliation: University of Sao Paulo, Brazil.
authors.forename: Renata
authors.initials: R
authors.lastname: Miossi
authors.forename: Fabiana B
authors.initials: FB
authors.lastname: Benatti
authors.forename: Ana
authors.initials: A
authors.lastname: Lúciade de Sá Pinto
authors.forename: Fernanda R
authors.initials: FR
authors.lastname: Lima
authors.forename: Eduardo F
authors.initials: EF
authors.lastname: Borba
authors.forename: Danilo M L
authors.initials: DM
authors.lastname: Prado
authors.forename: Luiz Augusto
authors.initials: LA
authors.lastname: Perandini
authors.forename: Bruno
authors.initials: B
authors.lastname: Gualano
authors.forename: Eloisa
authors.initials: E
authors.lastname: Bonfá
authors.forename: Hamilton
authors.initials: H
authors.lastname: Roschel
mesh_terms: D000328:Adult; D019454:Chronotherapy / Q000379:methods*; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test / Q000379:methods; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D020127:Recovery of Function / Q000502:physiology*; D016896:Treatment Outcome