Article Text

Download PDFPDF

  1. Gizem Irem Kinikli1,
  2. Susanne Pettersson2,
  3. Sevilay Karahan3,
  4. Elisabet Svenungsson4,
  5. Carina Boström5
  1. 1Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey
  2. 2Karolinska Institutet, Inflammation and Infection Theme, Karolinska University Hospital and Department of Neurobiology, care sciences and society, Stockholm, Sweden
  3. 3Hacettepe University, Faculty of Medicine, Department of Biostatistics, Ankara, Turkey
  4. 4Karolinska University Hospital, Unit of Rheumatology, Department of Medicine, Stockholm, Sweden
  5. 5Karolinska Institutet, Department of Neurobiology, care sciences and society, Stockholm, Sweden


Background Physical activity and exercise have many positive effects in patients with Systemic Lupus Erythematosus (SLE) (1) and poor self-reported physical function has been reported to predict mortality (2). To facilitate and improve physical activity/function, it is thus important to investigate what factors are associated with good physical function. Few previous studies have addressed these issues (3).

Objectives The aim of this study was to identify factors associated with good self-reported physical function, such as walking and running in individuals with SLE.

Methods A total of 198 patients (mean age: 51.516.1 years; BMI: 24.74.7 kg/m2) with SLE participated. The outcome, self-reported physical function was assessed with the question: How much do you think you can manage concerning walk, jog, and run? (From Physical Activity Questionnaire, PAQ). Disease activity was assessed using the SLAM-R and organ damage with SLICC/ACR-DI. The VAS part of EQ-5D, was used to assess self-reported health related quality of life (HRQL). Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety/depression levels. Self-reported exercise during the last year was assessed by questions from PAQ and sitting hours as well as physical activity level was determined from International Physical Activity Questionnaire Short Form (IPAQ-SF). Logistic regression analyses estimated the associations of the following independent variables: age, sex, BMI, disease activity, organ damage, HRQL and anxiety/depression levels, exercise last year, sitting hours and physical activity level, on the dependent variable self-reported physical function (PAQ-question). Statistical significance was defined as a p value <0.05.

Results Median SLAM-R was 6 (IQR:6), SLICC-DI was 1 (IQR:3), EQ-5D VAS was 72.2 (IQR:22.1) and depression level 4 (IQR:5). Median Self-reported exercise during the last year (PAQ) was exercise irregularly. Median sitting hours a day (IPAQ-SF) was <5 hours. Median physical activity level was moderate (IPAQ-SF). Age (p<0.001; Odds ratio:6.40), SLICC-DI (p=0.002; Odds ratio:4.02) and EQ-5D VAS (p<0.001; Odds ratio:4.20) were significantly associated with better self-reported physical function (Nagelkerke R Square=0.437).

Conclusion The results demonstrated that SLE-patients who report low physical function are older patients with more organ damage. However, patients who reported low HRQL also reported low physical function. Our results imply that patients with low self-reported HRQL are at risk for not being enough physically active. To break this vicious circle is a challenge for physicians and physical therapists that care for patients with SLE.

References [1] O’Dwyer T, Durcan L, Wilson F. Exercise and physical activity in systemic lupus erythematosus: A systematic review with meta-analyses. Semin Arthritis Rheum. 2017;47:204-215.

[2] Azizoddin DR, Jolly M, Arora S, Yelin E, Katz P. Patient Reported Outcomes Predict Mortality in Lupus. Arthritis Care Res (Hoboken). 2018 Aug 24. doi: 10.1002/acr.23734.

[3] Elera-Fitzcarrald C, Fuentes A, Gonzlez LA, Burgos PI, Alarcn GS, Ugarte-Gil MF. Factors affecting quality of life in patients with systemic lupus erythematosus: important considerations and potential interventions.Expert Rev Clin Immunol. 2018;14:915-931.

Disclosure of Interests None declared

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.