title: Supervised physical exercise improves endothelial function in patients with systemic lupus erythematosus.
abstract: OBJECTIVE
  The objective of this study was to evaluate the effect of supervised physical exercise on endothelial function, ergospirometric test variables and disease activity in SLE patients.
  
  
  METHODS
  We conducted a prospective study in which women with SLE who were available to perform physical exercise were allocated to the exercise group (EG) to practise supervised physical exercise for 1 h three times per week for 16 weeks. Those who were not available for this activity were allocated to the control group (CG). Intervention consisted of walking at a heart rate corresponding to the ventilatory 1 threshold obtained from ergospirometry and monitored by a frequency meter. At baseline (T0) and after 16 weeks (T16), patients were assessed for endothelial function by brachial artery (flow-mediated dilation), ergospirometry and disease activity (SLEDAI). Statistical analysis was performed through normality tests, Student's t-test and non-parametric tests for data with non-normal distribution. P < 0.05 was considered significant.
  
  
  RESULTS
  Eighteen patients were allocated in the EG and 20 in the CG. After 16 weeks there was an increase in FMD in the EG [6.3 (6.7)% vs 14.1 (9.1)%, P = 0.006] without a change in the CG [8.4 (8.2)% vs 9.4 (5.7)%, P = 0.598]. Regarding the ergospirometric test, we found improvement in exercise tolerance [12.3 (2.4) vs 13.4 (2.6) min, P = 0.027], maximum speed [7.7 (1.0) vs 8.3 (1.2) km/h, P = 0.027] and threshold speed [5.6 (0.7) vs 6.1 (0.9) km/h, P = 0.005] in the EG without a difference in the CG. There was no difference in the SLEDAI score in both groups.
  
  
  CONCLUSIONS
  Physical exercise is a useful strategy to improve endothelial function and aerobic capacity without worsening disease activity in SLE patients. TRIAL REGISTRATION; ClinicalTrials.gov (http://www.clinicaltrials.gov), NCT01712529.
authors: Rheumatology Division, Department of Medicine, Universidade Federal de São Paulo, Rua Botucatu, 720, CEP 04023 900 São Paulo, SP, Brazil. eisato@unifesp.br.
authors: Edgard Torres
authors: ET
authors: dos Reis-Neto
authors: Aline Evelyn
authors: AE
authors: da Silva
authors: Carlos Manoel de Castro
authors: CM
authors: Monteiro
authors: Luciano Monteiro
authors: LM
authors: de Camargo
authors: Emilia Inoue
authors: EI
authors: Sato
mesh_terms: D000293:Adolescent; D000328:Adult; D002318:Cardiovascular Diseases / Q000503:physiopathology*; D023801:Directly Observed Therapy / Q000379:methods; D004730:Endothelium, Vascular / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000503:physiopathology* / Q000628:therapy*; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013147:Spirometry; D055815:Young Adult
keywords: endothelium; exercise; systemic lupus erythematosus