Low physical activity has been reported in systemic lupus erythematosus (SLE). It has been noted that patients with SLE exercise less than population controls and patients with more organ damage are less physically active at low-to-moderate intensity than controls. Studies state that between 23- and 59% of patients are physically inactive. According to one author, around 70% of patients with SLE have a sedentary lifestyle but in another report the number of such patients is lower (15%), and more are sedentary than controls are (9%). Elsewhere, 18% of patients and 26% of population controls reported sitting down almost the whole day (ns). These divergent results can possibly be explained by the lack of definitions and consensus concerning concepts related to sedentary lifestyle. There are many reasons for patients with SLE to be physically active: reduced aerobic and exercise capacity and muscular strength, pain, fatigue, anxiety, depression and the risk of osteoporosis and cardiovascular diseases. Earlier studies of 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. However, the studies are few, long-term studies are lacking and results on aerobic capacity concerning physical training with less supervision or no supervision are contradictory: more studies are needed. Also, potential cardiovascular benefits of exercise need investigation as low physical activity is associated with increased subclinical atherosclerosis and pro-inflammatory high-density lipoprotein in patients with SLE. Further, SLE-associated stiffening of the central artery and aorta wave reflection have not been observed in habitually exercising adults with SLE.
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