Telehealth-supervised exercise in systemic lupus erythematosus : A pilot study

Journal article


Frade, Stephanie, O’Neill, Sean, Walsh, Samantha, Campbell, Chloe, Greene, David Anthony, Bird, Stephen P. and Cameron, Melainie. (2023). Telehealth-supervised exercise in systemic lupus erythematosus : A pilot study. Lupus. 32(4), pp. 508-520. https://doi.org/10.1177/09612033231157073
AuthorsFrade, Stephanie, O’Neill, Sean, Walsh, Samantha, Campbell, Chloe, Greene, David Anthony, Bird, Stephen P. and Cameron, Melainie
Abstract

Objectives: To explore the feasibility and effectiveness of telehealth-supervised exercise for adults with Systemic lupus erythematosus (SLE).

Methods: This was a non-randomised controlled pilot trial comparing telehealth-supervised exercise (8 weeks, 2 days/week, 45 min, moderate intensity) plus usual care with usual care alone. Mixed methods were used to assess change in fatigue (FACIT-fatigue), quality of life (SF36), resting fatigue and pain (11-point scale), lower body strength (five-time sit-to-stand) and endurance (30 s sit-to-stand), upper body endurance (30 s arm curl), aerobic capacity (2 min step test), and experience (survey and interviews). Group comparison was performed statistically using a two-sample T-test or Mann–Whitney U-test. Where known, we used MCID or MCII, or assumed a change of 10%, to determine clinically meaningful change within groups over time. Interviews were analysed using reflexive thematic analysis.

Results: Fifteen female adults with SLE were included (control group n = 7, exercise group n = 8). Statistically significant differences between groups, in favour of the exercise intervention, were noted for SF36 domain emotional well-being (p = 0.048) and resting fatigue (p = 0.012). There were clinically meaningful improvements over time for FACIT-fatigue (+6.3 ± 8.3, MCID >5.9), SF36 domains physical role functioning (+30%), emotional role functioning (+55%), energy/fatigue (+26%), emotional well-being (+19%), social functioning (+30%), resting pain (−32%), and upper body endurance (+23%) within the exercise group. Exercise attendance was high (98%, 110/112 sessions); participants strongly agreed (n = 5/7, 71%) or agreed (n = 2/7, 29%) they would do telehealth-supervised exercise again and were satisfied with the experience. Four themes emerged: (1) ease and efficiency of exercising from home, (2) value of live exercise instruction, (3) challenges of exercising at home, and (4) continuation of telehealth-supervised exercise sessions.

Conclusion: Key findings from this mixed-method investigation suggest that telehealth-supervised exercise was feasible for, and well-accepted by, adults with SLE and resulted in some modest health improvements. We recommend a follow-up RCT with more SLE participants.

Keywordssystemic lupus erythematosus, exercise, autoimmune disease, telehealth, COVID-19
Year01 Jan 2023
JournalLupus
Journal citation32 (4), pp. 508-520
PublisherSage Publications Ltd. (UK)
ISSN0961-2033
Digital Object Identifier (DOI)https://doi.org/10.1177/09612033231157073
PubMed ID36803286
Web address (URL)https://journals.sagepub.com/doi/10.1177/09612033231157073
Open accessPublished as ‘gold’ (paid) open access
Research or scholarlyResearch
Page range508-520
Publisher's version
License
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Open
Output statusPublished
Publication dates
PrintApr 2023
Publication process dates
Accepted24 Jan 2023
Deposited22 Jul 2024
Additional information

© The Author(s) 2023.

This article is distributed under the terms of the Creative Commons Attribution 4.0 License ( https://creativecommons.org/licenses/by/4.0/ ) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).

Place of publicationUnited Kingdom
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