How exercise can help combat Lupus related Fatigue

Exercise and fatigue - sounds contradicting right? Well here is the evidence to prove that exercise really can help combat Lupus related fatigue.

Fatigue is one of the most common symptoms and often the most disabling one experienced by individuals with SLE, affecting up to 80% of patients.

A poll was conducted in August, 2016 on patients with lupus from an online support group in Australia, to identify the most common symptoms experienced (see graph below). It is evident that fatigue is the highest reported symptom amongst this population group, followed by joint pain, ‘fuzzy head’ and the inability to reach potential.

This data below, along with published articles, outlines the increasing need to address this issue and provide these patients with information to improve their quality of life.

Fatigue is a symptom that could be related to various reasons, i.e. the disease activity itself, side effects of medication, depression/anxiety associated with having a chronic illness and/or side effects to medication.

What does the research tell us? ….

Exercise helps with fatigue in several ways and there is reliable research to prove its benefits in this population group. It increases muscle mass and strength, which make movement easier. It also increases blood circulation and flexibility, which reduce pain. In addition, exercise generates endorphins, which are brain chemicals that produce a sense of well-being and energy

Some patients with Lupus report that they are afraid to exercise because they don’t want to exhaust themselves, fearing that they may trigger an immune response. Research on SLE indicate that aerobic capacity and muscular strength, and also aspects of health-related quality of life such as fatigue and depression, improve from aerobic exercise and physical training. These study results also indicate that aerobic exercise is safe, showing no increase in disease activity and organ damage in patients with low-to moderate disease activity and low disease severity.

Other studies on physical exercise report that aerobic activity is safe for SLE patients, leading to an increase of tolerance to exercise, physical and functional capacity for those with moderate or low activity. A reduction in fatigue, anxiety and depression, as well as improved quality of life, is also suggested though evidence for these outcomes is limited.

A Meta-analysis and literature review reveal that 6/11 studies reported statistically significant reductions in fatigue from aerobic exercise interventions. The interventions involved supervised exercise classes, including warm up, low impact aerobic activity, and strengthening or stretching before cool down. It also included home- based programmes making use of exercise bicycles, walking, cycling, jogging or swimming. The duration of effective aerobic exercise programmes averaged 12 weeks, with most interventions occurring three times weekly for 30–60 minutes. The Medical Outcome Short Form (SF-36) and Profile of Mood States (POMS) were the most commonly used composite instruments in all three autoimmune conditions.Overall, the review suggests that aerobic exercise, either home-based or in supervised classes, is an effective non- pharmacological means of managing fatigue for some people with MS, RA and SLE. Low-impact aerobics, walking, cycling, and jogging were effective interventions.

Exercising with Lupus fatigue, keeping it simple.

Understand and accept that It’s ok to rest. Exercise on days that you feel like your energy is up and allow your body to rest on days when you feel like its really needed.
Choose the right type of exercise. On the days that your energy is low, allow your body to rest, and if you do get that little bit of energy back that day try something lighter in intensity i.e gentle walk, home-based stretches.
Efficiency is key. If fatigue is getting the better of you the last thing you want to do is spend hours exercising. Get your exercise done short and sweet, this way you won’t over do yourself. Focus on compound exercises that use more than one muscle group and choose your preferred exercises.
Pace yourself. Start gradually and build up slowly. Starting with too much or increasing too quickly can bring on symptoms and set you up for disappointment when you don’ meet that the next week. Use the 10% rule to gauge how much to increase, that is, increase the duration and intensity of your workout by 10% per week.
Set small, short term goals. Having Lupus comes with its ups and downs so you never know whats around the corner. Setting long term unachievable goals will only set you up for disappointment. Try focusing on setting small incremental goals, this way you are more likely to achieve the smaller goals and keep a positive mindset.