Background/Purpose: Recent studies have shown increased cardiovascular risk in patients with primary Sjögren’s syndrome (pSS). As physical exercise is one of the pillars in primary and secondary prophylaxis of cardiovascular events, we evaluated whether the combination of resistance and aerobic exercises is able to increase aerobic capacity and quality of life and to improve echocardiographic parameters and the metabolic profile of patients with this rheumatic disease.

Methods: 60 women with pSS (age 18-90 years) were evaluated from the SF-36 Short-Form Health Survey (SF-36) and EULAR Sjögren’s Syndrome Disease Activity Index (ESSDAI) questionnaires. The participants performed ergospirometry in an electromagnetic braking cycle ergometer (Lode Excalibur Sport, Groningen, The Netherlands), coupled to a computerized gas analyzer (Quark CPET, Cosmed, Italy) and echocardiography on the Philips IE33 device; blood samples were collected to evaluate the metabolic profile (glycemia, glycated hemoglobin, total cholesterol and fractions) by the central laboratory of the Hospital São Paulo – UNIFESP. Patients were divided into 2 groups: a training group (30 patients) that participated in the supervised training program and a control group (30 patients) that did not participate in the program. All variables were analyzed at baseline and after 28 weeks for both groups. The training program was divided into two phases according to the nature of the exercise. The first stage consisted of 16 weeks of resistance exercises, in the form of a 45 minute circuit, and each muscle group was exercised in 3 sets of 12 repetitions each. From the seventeenth week, the exercise became aerobic, performed on an electromagnetic braking cycle ergometer (Lode Excalibur Sport, Groningen, The Netherlands), the same instrument used to perform the ergospirometric test. The intensity and duration of the training increased progressively, until the last 3 weeks with sessions of 50 minutes and intensity of 60 to 84% of the VO₂max. Statistical analysis included Wilcoxon’s rank sum test, chi-square test, and ANOVA test. P values <0.05 were considered to be statistically significant.

Results: The 2 groups were homogeneous and comparable at baseline. The training group showed a significant improvement in aerobic capacity measured by oxygen maximum volume (VO₂max) (19.64 ± 3.47vs 22.95 ± 4.01, p <0.001) and by anaerobic threshold VO₂ (16.86 ± 2.86 vs 19.56 ± 3.18, p <0.001) Comparison of the training group and control group after 28 weeks showed a significant difference relating to VO₂max [F (1; 58) = 31.43; p <0.001] and in the anaerobic threshold VO₂ [F (1; 58) = 5.41; p <0.001] After cardiovascular training, we found a small but significant decrease in glycated hemoglobin (5.88 ± 0.73 vs 5.75 ± 0.66, p = 0.006). We did not find statistically significant difference in echocardiographic parameters, lipemic profile, quality of life (SF-36) and disease activity (ESSDAI).

Conclusion: This study showed significant improvement in aerobic capacity and glycated hemoglobin after a supervised training program in patients with pSS with safety.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/exercise-increases-aerobic-capacity-in-primary-sjogrens-syndrome-a-randomized-controlled-trial/