ABSTRACT
OBJECTIVE: To test the efficacy of a graded aerobic exercise programme in treating fatigue in systemic lupus erythematosus. METHODS: Ninety-three patients with systemic lupus erythematosus without active disease in any major organ were randomized, using a minimization protocol, to 12 weeks of graded exercise therapy, relaxation therapy or no intervention. RESULTS: Analysis by intention to treat showed that 16 of the 33 (49%) patients in the exercise group rated themselves as 'much' or 'very much' better compared with eight out of 29 (28%) in the relaxation group and five out of 32 (16%) in the control group (chi2=8.3, df=2, P=0.02). Fatigue improved significantly on one out of three measures after exercise therapy and there was a trend for fatigue to improve on all measures after exercise. CONCLUSION: These findings support the use of appropriately prescribed graded aerobic exercise in the management of patients with fatigue and systemic lupus erythematosus.
Subject(s)
Exercise Therapy , Fatigue/rehabilitation , Lupus Erythematosus, Systemic/complications , Adolescent , Adult , Fatigue/etiology , Fatigue/physiopathology , Female , Follow-Up Studies , Humans , Lupus Erythematosus, Systemic/physiopathology , Middle Aged , Patient Compliance , Patient Dropouts , Patient Satisfaction , Relaxation Therapy , Treatment OutcomeABSTRACT
OBJECTIVE: This study assessed the prevalence and associations of fatigue in systemic lupus erythematosus (SLE). METHODS: Questionnaires were used to measure self-reported fatigue, disease activity, sleep quality, quality of life, anxiety and depression in 120 out-patients with SLE. RESULTS: Abnormal fatigue was reported by 97 (81%) patients, and 71 (60%) patients reported poor sleep quality. Fatigue correlated negatively with all measures of functioning. Fatigue scores were up to 33% higher in patients with active disease [Systemic Lupus Activity Measure (SLAM >/=3)] than in patients with inactive disease (SLAM >3) (P: < 0.05). There were significant correlations between fatigue and disease activity, sleep quality, anxiety and depression. CONCLUSION: Fatigue is a common complaint of patients with SLE and is associated with diminished ability to function. Apart from treating the primary disease, it may also be worthwhile to treat mood disorders and insomnia in order to reduce fatigue and improve quality of life.
Subject(s)
Fatigue/epidemiology , Lupus Erythematosus, Systemic/epidemiology , Adult , Affect , Anxiety/epidemiology , Anxiety/psychology , Depression/epidemiology , Depression/psychology , Fatigue/psychology , Female , Humans , Lupus Erythematosus, Systemic/psychology , Middle Aged , Prevalence , Quality of Life , Severity of Illness Index , Sleep Wake Disorders/epidemiology , Sleep Wake Disorders/psychologyABSTRACT
OBJECTIVE: To assess how anti-ENA characteristics change in patients with systemic lupus erythematosus from different ethnic backgrounds over a 10-year period follow-up study. RESULTS: There were 61 patients, of whom 37 were Caucasian, 12 were Asian and 12 were Afro-Caribbean. At the first available bleed 12/37 (32%) Caucasians were anti-ENA positive compared to 6/12 (50%) Asians and 9/12 (75%) of Afro-Caribbeans (Chi-squared P=0.01 for Caucasian vs Afro-Caribbean) and these proportions remained essentially unchanged after 10 y of follow-up. However, over the 10 y of follow-up anti-ENA patterns did change, with anti-Ro being the commonest antibody pattern to emerge and anti-Ro/La the commonest antibody pattern to disappear. There were 20/37(54%) Caucasians, 1/12(8%) Afro-Caribbeans and 5/12(42%) Asians who remained negative for anti-ENA throughout the 10-year follow-up (Chi-squared P=0.03 for Caucasian vs Afro-Caribbean). CONCLUSION: Anti-ENA were more commonly found in the Afro-Caribbean than the Caucasian population. The commonest patterns of anti-ENA differ between ethnic groups and, over a 10-year period, anti-ENA patterns in individual patients changed in a significant number of individuals. However, Caucasians were more likely to remain anti-ENA negative over 10 y of follow-up than Afro-Caribbeans.
Subject(s)
Antibodies, Antinuclear/immunology , Lupus Erythematosus, Systemic/immunology , Adult , Antibody Specificity , Female , Humans , Lupus Erythematosus, Systemic/ethnology , Male , Middle Aged , Racial GroupsABSTRACT
The aim of this study was to gain an overview of rheumatology resources on the World Wide Web (WWW). A list of websites was generated using a commercial search engine and 'rheumatology' as a key word. A total of 154 websites were then evaluated with respect to origin and likely target audience; 43% of this initial group were either not accessible, repeats, or in a language other than English. Of the 87 websites we were able to analyse, we found that 67% originated from medical organizations and 51% were interpreted to be directed specifically at rheumatologists. Only 16% of websites were directed at patients only. The remainder were felt to contain information useful to both groups. Over half the websites felt to be of interest to patients contained advertisements. Although there is a lot of information relating to rheumatology on the WWW, it was invariably time consuming to access and there was little directed solely at patient education.
