Toggle Main Menu Toggle Search

Open Access padlockePrints

Supervised walking improves cardiorespiratory fitness, exercise tolerance, and fatigue in women with primary Sjögren’s syndrome: a randomized-controlled trial

Lookup NU author(s): Professor Fai NgORCiD, Dr Dennis LendremORCiD, Professor Mike TrenellORCiD



This is the authors' accepted manuscript of an article that has been published in its final definitive form by Springer Verlag, 2019.

For re-use rights please refer to the publisher's terms and conditions.


© 2019, Springer-Verlag GmbH Germany, part of Springer Nature. Objective: The aim of this study was to evaluate the safety and effectiveness of a supervised walking program in women with primary Sjögren’s syndrome (pSS). Methods: Forty-five sedentary women fulfilling the American European Consensus Criteria for pSS were randomized to a training group (TG, n = 23) or control group (CG, n = 22). Patients in the TG were submitted to supervise walking three times a week for 16 weeks. The patients of the CG were instructed to not perform any kind of regular physical exercise. Physical fitness [maximum oxygen uptake (VO2max) and distance], EULAR Sjögren’s Syndrome Disease Activity Index (ESSDAI), hematological tests, and Medical Outcomes Study 36 (SF-36) were assessed at baseline and week 16. In addition, EULAR Sjögren’s Syndrome Patient Reported Index (ESSPRI), Functional Assessment of Chronic Illness Therapy Fatigue Subscale (FACIT-fatigue), and Beck Depression Inventory (BDI) were measured prior to intervention, after 8 and 16 weeks. Patient global assessment of response to therapy was completed at the final assessment. An intent-to-treat analysis was performed. Results: After 16 weeks, the mean change of VO2max (ml/kg/min), distance, and FACIT-fatigue were higher in the TG than in the CG (p = 0.016, p = 0.043 and p = 0.030, respectively). Improved cardiorespiratory fitness was associated with improvements in fatigue scores and physical components of quality of life (SF-36). Furthermore, improved fatigue scores were associated with reduced depression and improvements in the physical and mental components of SF-36. Overall, 95.4% of patients in the TG rated themselves as clinically improved versus 62% of the patients in the CG (p = 0.049). There was no flare in disease activity and no serious adverse events with exercise. Conclusions: This supervised walking program was demonstrated to be feasible and safe with improvements in cardiorespiratory fitness, exercise tolerance, fatigue, and patient perception of improvement in pSS patients. Trial registration: Clinical ID, number NCT02370225.

Publication metadata

Author(s): Miyamoto ST, Valim V, Carletti L, Ng W-F, Perez AJ, Lendrem DW, Trennel M, Giovelli RA, Dias LH, Serrano EV, Subtil AM, Abreu VC, Natour J

Publication type: Article

Publication status: Published

Journal: Rheumatology International

Year: 2019

Volume: 39

Issue: 2

Pages: 227-238

Print publication date: 01/02/2019

Online publication date: 02/01/2019

Acceptance date: 24/11/2018

Date deposited: 03/06/2019

ISSN (print): 0172-8172

ISSN (electronic): 1437-160X

Publisher: Springer Verlag


DOI: 10.1007/s00296-018-4213-z


Altmetrics provided by Altmetric