The Effectiveness of Exercise Program for Aerobic Fitness in Adults with Systemic Lupus Erythematosus: A Systematic Review and Meta-Analysis

Purpose:  The purpose of this research aims to review current knowledge concerning the effectiveness of exercise program for cardiopulmonary function among systemic lupus erythematosus (SLE) patients. Furthermore, a meta-analysis was performed to examine the cumulative evidence of aerobic fitness.

Methods:  Studies were identified through a systemic search process. The keywords used were exercise, physical exercise, therapeutic exercise, supervised exercise, exercise therapy, physical fitness, physical activity, exercise training, aerobic training, walking, bicycling, yoga, dancing, or jogging in combination with lupus or systemic lupus erythematosus. Inclusion criteria were experimental study, the intervention consists of a physical exercise program with at least 8 weeks duration, the outcome measures including any cardiopulmonary function parameter, and was an original study. Age under 18, animal study, not English, no control group or qualitative study were excluded. The databases searched were PubMed, CINAHL, Cochrane Library, and PsychINFO from their inception to November 2013. The quality of each selected study was assessed by CONSORT checklist. Data was analyzed using Cochrane Collaboration’s Revman 5.2.

Results:  Five RCTs and one quesi-experimental study with 234 subjects were included in this systemic review. In addition, four studies with 194 subjects were included in the meta-analysis. Five studies conducted supervised exercise program and one study conducted home based exercise program. Walking was the primary exercise type. Meta-analysis showed that exercise could improve exercise tolerance (mean difference (MD) 1.95, 95% CI 1.66,2.24 , p-value 0.00), maximum O2 consumption (VO_2max) (MD 0.83, 95% CI 0.31,1.35, p-value 0.002), and maximum pulmonary ventilation (VE_max) (MD 2.56, 95% CI 1.14,3.98, p-value 0.00).

Conclusion:  The present data indicate that at least 8 weeks exercise program benefits cardiopulmonary function among SLE patients. However, there is limited study and subjects. It was not possible to make recommendation on exercise type and exercise program. In the future research, large sample size and different type of exercise are needed.