Efeitos do exercício de vibração de corpo inteiro na fadiga, na funcionalidade e na qualidade de vida de mulheres com lúpus eritematoso sistêmico em uso crônico de glicocorticoides

Abstract

Systemic lupus erythematosus (SLE) is an autoimmune, chronic, and systemic disease. The use of glucocorticoid (GC) is one of the pharmacological strategies for the control and release of symptoms. Prolonged use of the medication can lead to complications, as muscle impairment, leading to fatigue, reduced functional ability and limitation of daily living activities. These may be associated with poor quality of life. Physical exercises can be a strategy to improve muscle strength and control fatigue. Whole-body vibration exercise (WBVE) can lead benefits to balance and strength, improvement of proprioception and body composition (bone, muscle and adipose) of healthy or diseased individuals, including chronic diseases and may be an alternative exercise modality for SLE patients. The aim was to evaluate the effect of WBVE on the fatigue, functional ability and quality of female patients with SLE in chronic glucocorticoid use. The study involved twenty-one women with SLE, treated at the Department of Rheumatology of the Hospital Universitário Pedro Ernesto, that used glucocorticoids for at least three years, who were allocated randomly in the "WBVE group" or in the "isometry group". The women were positioned on the vibrating platform base with knee flexion at 130º, in the WBVE group they underwent the intervention with WBVE twice a week for 12 weeks. The isometry group performed the protocol in the same position of the WBVE group and the same intervention time, however without the stimulus of mechanical vibration (with a vibrating platform off). Fatigue was evaluated through the Fatigue Assessment of Chronic Illness Therapy -FATIGUE (FACIT-F) scale, the functional ability by the Health Assessment Questionnaire (HAQ) in Portuguese and the Timed up and go (TUG) test, and quality of life by the Medical Outcomes Study-Short Form 36 (SF-36) questionnaire at weeks 0, 6, and 12. Fatigue improvement was evidenced in the WBVE group at 6 and 12 weeks of intervention (p = 0.04) and (p = 0.03) respectively. There was a significant difference in the functional ability evaluated by the HAQ in the WBVE group when compared to the isometry group (p = 0.03). After adjusting for the skeletal mass index the difference observed between groups was -0.30 (-0.62 a 0.02 95% CI / p = 0.06). In the isometry group, there was a significant difference in the functional capacity domain of the SF-36 (p = 0.03) in 12 weeks, compared to baseline. WBVE has shown to be feasible and safe and seems to be a useful therapeutic tool for the control of fatigue and the improvement of the functional ability of women with SLE in chronic glucocorticoid use.