A pilot study on the effects of exercise in patients with systemic lupus erythematosus. Aerobic fitness, fatigue, and physical disability in systemic lupus erythematosus. Fatigue in systemic lupus erythematosus: a randomized controlled trial of exercise. Assessments of fatigue and disease activity in patients with systemic lupus erythematosus enrolled in the Phase 2 clinical trial with blisibimod Effects of dehydroepiandrosterone on fatigue and well-being in women with quiescent systemic lupus erythematosus: a randomised controlled trial Consistency and validity of patient administered assessment of quality of life by the MOS SF-36; its association with disease activity and damage in patients with systemic lupus erythematosus. Effectiveness of minimally supervised home aerobic training in patients with systemic rheumatic disease. Counterbalancing patient demands with evidence: Results from a pan-canadian randomized clinical trial of brief supportive-expressive group psychotherapy for women with systemic lupus erythematosus Effects of supervised cardiovascular training program on exercise tolerance, aerobic capacity, and quality of life in patients with systemic lupus erythematosus. Effects of a one-year physical activity programme for women with systemic lupus erythematosus – a randomized controlled study Predictors of exercise and effects of exercise on symptoms, function, aerobic fitness, and disease outcomes of rheumatoid arthritis. The effect of brief exercise cessation on pain, fatigue, and mood symptom development in healthy, fit individuals. Testosterone patches in the management of patients with mild/moderate systemic lupus erythematosus. Intensive aerobic and muscle endurance exercise in patients with systemic sclerosis: a pilot study A prospective study of factors affecting quality of life in systemic lupus erythematosus. A single-blind randomized controlled trial to evaluate the effect of 6 months of progressive aerobic exercise training in patients with uraemic restless legs syndrome. Exercising Impacts on Fatigue, Depression, and Paresthesia in Female Patients with Multiple Sclerosis.
OBJECTIVE A pilot study was design ed to assess the efficacy and safety of different exercise therapies on  patient-reported fatigue and functional status .  METHODS Ten patients with systemic lupus erythematosus ( SLE ) were r and omly placed in either an aerobic exercise group ( group 1 : n = 5 ) or a range of motion/muscle strengthening ( ROM/MS ) exercise group ( group 2 : n = 5 ) . Outcome measures assessed at baseline and the end of the study were fatigue , functional status , disease activity , cardiovascular fitness , isometric strength , bone mineral density ( BMD ) of the lumbar spine and femoral neck , and parathyroid hormone and osteocalcin as representative bone biochemical markers for bone resorption and bone formation , respectively . RESULTS Both aerobic and ROM/MS types of exercise were safe and did not worsen SLE disease activity . Patients in both exercise groups showed some improvement in fatigue , functional status , cardiovascular fitness , and muscle strength . Both groups showed increased bone turnover , but BMD was unchanged . Eighty percent of the patients met the compliance st and ard for the study . CONCLUSIONS This pilot study shows the feasibility of exercise for SLE patients . The potential value of this approach shows promise in the routine management of these patients OBJECTIVE To measure aerobic fitness , muscle strength , fatigue , and physical disability in patients with systemic lupus erythematosus ( SLE ) . METHODS Ninety-three patients with SLE and 41 sedentary controls were recruited into the study . Aerobic fitness was assessed by monitoring peak and submaximal oxygen uptake , heart rate , duration of exercise , and perceived exertion during a treadmill-walking test . Strength was measured using voluntary isometric quadriceps contraction . Symptomatic measures included physical and mental fatigue , mood , sleep , and functional incapacity . RESULTS Compared to sedentary controls patients with SLE had significantly reduced levels of aerobic fitness ( mean VO2peak SLE patients , 23.2 ml/kg/min vs controls , 29.6 ml/kg/min ; p < 0.001 ) and reduced exercise capacity ( mean exercise duration SLE patients , 10.4 min vs controls , 13.1 min ; p < 0.001 ) . The SLE patients also had reduced muscle strength ( mean maximum voluntary quadriceps contraction SLE patients , 298 N vs controls , 376 N ; p = 0.003 ) . Resting lung function was also significantly worse in the SLE patients ( mean FEV , SLE patients , 2.6 l vs controls , 2.9 l ; p = 0.002 ) . Fatigue ( p < 0.001 ) , depressed mood ( p < 0.001 ) , poor sleep quality ( p < 0.001 ) , and functional incapacity ( p < 0.001 ) were all significantly greater in the SLE patients . Linear regression models suggested that physical disability correlated with aerobic fitness ( p < 0.001 ) , fatigue ( p = 0.005 ) , body mass index ( p = 0.01 ) , and depression ( p = 0.05 ) and that fatigue correlated with depression ( p < 0.001 ) . CONCLUSION Patients with SLE were less fit with reduced exercise capacity , reduced muscle strength , more fatigue , and greater disability compared to sedentary controls . Treatments developed to manage depression and improve aerobic fitness should be considered in the overall treatment of fatigue and disability in SLE OBJECTIVE To test the efficacy of a grade d 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 r and omized , using a minimization protocol , to 12 weeks of grade d 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 grade d aerobic exercise in the management of patients with fatigue and systemic lupus erythematosus This report evaluates the effects of blisibimod ( A-623 , AMG 623 ) , a potent and selective inhibitor of B-cell activating factor ( BAFF ) , on patient-reported fatigue and disease activity in the Phase 2b PEARL-SC clinical trial in patients with systemic lupus erythematosus ( SLE ) . A total of 547 individuals who met the American College of Rheumatology ( ACR ) classification criteria for SLE , were positive for anti-double-str and ed DNA or antinuclear antibodies , and had a Safety of Estrogens in Lupus Erythematosus National Assessment -Systemic Lupus Erythematosus Disease Activity Index ( SELENA-SLEDAI ) score ≥6 at baseline , were r and omized to receive placebo or blisibimod for at least 24 weeks . Patient self-reported fatigue was evaluated using the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue scale , and disease activity was evaluated using Physician ’s Global Assessment , SELENA-SLEDAI , and British Isles Lupus Assessment Group Score . Statistically significant improvements in FACIT-Fatigue score were observed among individuals r and omized to blisibimod , especially in the 200 mg QW group where favorable effects on disease activity with blisibimod compared to placebo were observed as early as Week 8 . The mean improvement from baseline of 6.9 points at Week 24 , compared with 4.4 points with placebo , met the criteria for minimal clinical ly important improvement difference defined for patients with SLE . Despite concomitant improvements in FACIT-Fatigue , SLE Responder Index ( SRI ) and SLE biomarkers ( reported previously ) , FACIT-Fatigue score correlated only weakly with disease activity . While poor correlation between fatigue and disease activity is not new , the observation that correlation remains poor despite concurrent population improvements in disease and fatigue brings a new facet to our underst and ing of SLE Objective Dehydroepi and rosterone ( DHEA ) has been reported to improve fatigue and reduced well-being . Both are major problems in patients with systemic lupus erythematosus ( SLE ) , even with quiescent disease . Low serum DHEA levels are common in SLE . The present work investigates the effects of DHEA administration on fatigue , well-being and functioning in women with inactive SLE . Methods In a double-blind , r and omised , placebo-controlled study , 60 female patients with inactive SLE received 200 mg oral DHEA or placebo . Primary outcome measures were general fatigue , depressive mood , mental well-being and physical functioning . Assessment s were made before treatment , after 3 , 6 and 12 months on medication , and 6 months after cessation of treatment . Results Patients from the DHEA and placebo group improved on general fatigue ( p<0.001 ) and mental well-being ( p=0.04 ) . There was no differential effect of DHEA .  The belief that DHEA had been used was a stronger predictor for improvement of general fatigue than the actual use of DHEA ( p=0.04 ) . Conclusions The trial does not indicate an effect of daily 200 mg oral DHEA on fatigue and well-being , and therefore DHEA treatment is not recommended in unselected female patients with quiescent SLE . Clinical Trials Registration Number OBJECTIVE To investigate the metric properties and validity of the assessment of  quality of life by the MOS Short Form 36 ( SF-36 ) in patients with systemic lupus erythematosus ( SLE ) and to examine the effect of disease on quality of life . METHODS Cross sectional study of 150 patients with SLE ( age : mean 39.7 yrs , SD 11.4 yrs ; 95 % female ) attending 2 specialist lupus clinics between November 1994 and April 1995 . Shortly before or after the consultation patients completed the SF-36 and the  MOS SF-20  with an additional question about fatigue ( SF-20 + ) in r and om order . Disease activity was measured by the  British Isles Lupus Activity Group System ( BILAG ) , disease damage by the Systemic Lupus International Collaborating Clinics/American College of Rheumatology ( SLICC/ACR ) damage index ( SLICC ) . RESULTS SF-36 domains were shown to be internally consistent ( Cronbach 's coefficient alpha > or = 0.71 ) . Significant associations of the SF-36 domains with the corresponding domains of the SF-20 + and with global disease activity measured by BILAG were observed . SF-36 scores in patients with SLE were significantly lower than in controls . Different disease activity levels were significantly associated with different quality of life scores , with excellent ability to record the continuum from good health to serious illness by the SF-36 . Disease activity had greater effect on quality of life than age , cumulative damage , or disease duration . CONCLUSION This study shows the SF-36 is internally consistent and proves construct , discriminatory , and criterion validity for the SF-36 and construct validity for the SF-20 + in patients with SLE . The SF-36 is preferred because of its broader scope of questions , its widespread use , and previous international validation for a wide variety of diseases The effectiveness of an exercise prescription and unsupervised home exercise programme was tested on 37 subjects with rheumatoid arthritis and 34 with systemic lupus erythematosus . Subjects were r and omly assigned to control or stationary bicycling at home , using loaned bicycles . Exercise subjects ( with bicycles ) did better than controls , but not significantly , on all outcome d measures ( exercise tolerance test , fatigue , depression and helplessness ) at 3 months . Bicycles were recl aim ed at 3 months and all subjects in both groups given instructions for home exercise . Exercise in the second 3 months was predicted primarily by baseline exercise habits and fatigue . It is concluded that although safe , unsupervised home exercise programmes may benefit few patients . Future research should address methods of stimulating and maintaining unsupervised exercise programmes in patients with systemic rheumatic disease Objective : To evaluate the effect of Brief Supportive-Expressive Group Psychotherapy as an adjunct to st and ard medical care in reducing psychological distress , medical symptoms , and health care costs and improving quality of life in women with systemic lupus erythematosus ( SLE ) . Methods : A r and omized clinical trial was conducted with 133 SLE female patients from 9 clinics across Canada . Clinical and psychosocial measures were taken at baseline , posttreatment , and 6 and 12 months posttreatment . Outcomes assessed were psychological distress , quality of life , disease activity , health service utilization , and diminished productivity . Results : Intention-to-treat analyses revealed that there were no clinical ly important group differences on any of the outcome measures . Conclusion : Although both groups improved over time on several measures ( e.g. , decreases in psychological distress , stress , and emotion-oriented coping ) , these changes could not be attributed to the psychotherapeutic intervention . Thus , evidence does not support the referral of these patients to this type of intervention OBJECTIVE To determine if supervised cardiovascular training improves exercise tolerance , aerobic capacity , depression , functional capacity , and quality of life in patients with systemic lupus erythematosus ( SLE ) . METHODS Sixty women with SLE ( ages 18 - 55 years ) were evaluated using Short Form 36 , visual analog scale for pain , scale for fatigue , Beck Depression Inventory , and Health Assessment Question naire ( HAQ ) , and participated in a training protocol of incremental load on a treadmill with computed gas metabolic analysis .  Maximum oxygen consumption ( VO(2max ) ) and anaerobic threshold VO(2 ) were calculated with a SensorMedics Vmax29C analyzer ( Sensor Medics , Yorba Linda , CA ) , and heart rate was measured by electrocardiogram . Patients were divided into 2 groups : a training group ( 41 patients ) that participated in the supervised cardiovascular training program and a control group ( 19 patients ) that did not participate in the program . All variables were analyzed at baseline and after 12 weeks for both groups . The training program occurred in the morning for 60 minutes , 3 times a week for 12 weeks . Statistical analysis included Wilcoxon 's rank sum test , Mann-Whitney U test , chi-square test , and Fisher 's exact test . P values < 0.05 were considered to be statistically significant . RESULTS The 2 groups were homogeneous and comparable at baseline . The training group showed a significant improvement of aerobic capacity measured by anaerobic threshold VO(2 ) ( 14.67 + /- 3.03 versus 17.08 + /- 3.35 ml/kg/minute , P < 0.001 ) . Comparison of the training group and control group after 12 weeks showed a significant difference relating to VO(2max ) ( 24.31 + /- 4.61 versus 21.21 + /- 3.88 ml/kg/minute , P = 0.01 ) and anaerobic threshold VO(2 ) ( 17.08 + /- 3.35 versus 13.66 + /- 2.82 ml/kg/minute , P < 0.0001 ) . After cardiovascular training , we found a significant improvement of Beck inventory score ( 8.37 + /- 12.79 versus 2.90 + /- 3.00 , P < 0.001 ) and HAQ score ( 0.14 + /- 0.21 versus 0.06 + /- 0.19 , P < 0.01 ) in the training group . CONCLUSION This study showed significant improvement in exercise tolerance , aerobic capacity , quality of life , and depression after a supervised cardiovascular training program in patients with SLE Objectives To study the effects of a one-year physical activity programme on aerobic capacity , physical activity and health-related quality of life ( HRQL ) in patients with systemic lupus erythematosus ( SLE ) by a r and omized control design . Methods Thirty-five women with low or moderate disease activity and organ damage were r and omized to intervention ( I ) or control ( C ) group . The intervention during months 0–3 consisted of education , supervised aerobic exercise at high intensity and individual coaching , as well as self-managed physical activity at low-to-moderate intensity . During months 4–12 , the physical activity was self-managed and the coaching was successively reduced over time . Outcome measures included : maximal oxygen uptake ( VO2 max ) from a bicycle ergometer test , self-reported physical activity and HRQL ( SF-36 ) . Results VO2 at sub-max . and max . increased , independent of group , during the one-year study period ( main effect of time p < 0.0001 ) . VO2 max . increased between baseline and month 3 ( p < 0.0001 ) , between months 3 and 6 ( p = 0.01 ) and the increase was sustained at month 12 ( ns ) . Frequency of physical activity at high intensity also increased , independent of group , during the study period . It was increased at months 3 , 6 and 12 compared to baseline ( p = 0.02 , p < 0.001 , p = 0.03 ) . Improvement in mental health between baseline and month 6 ( p = 0.002 ) was seen for the I-group , not the C-group ( p = 0.03 ) . Disease activity and organ damage did not change . Conclusions Physical activity and aerobic capacity increased after supervised exercise and coaching , and the improvement was sustained during the one-year programme . However , no interactions between the group differences were seen , which suggests that repeated measurements could motivate to increased physical activity and thereby to increased aerobic capacity . As sub-max . VO2 increased over time , training-induced changes in VO2 on-kinetics could be another explanation . Little influence on HRQL was seen after the programme . The study indicates that physical activity at high intensity over one year is tolerated by patients with mild to moderate SLE OBJECTIVE To determine the effects of participation in a low-impact aerobic exercise program on fatigue , pain , and depression ; to examine whether intervention groups compared with a control group differed on functional ( grip strength and walk time ) and disease activity ( total joint count , erythrocyte sedimentation rate , and C-reactive protein ) measures and aerobic fitness at the end of the intervention ; and to test which factors predicted exercise participation . METHODS A convenience sample of 220 adults with rheumatoid arthritis ( RA ) , ages 40 - 70 , was r and omized to 1 of 3 groups : class exercise , home exercise using a videotape , and control group . Measures were obtained at baseline ( T1 ) , after 6 weeks of exercise ( T2 ) , and after 12 weeks of exercise ( T3 ) . RESULTS Using structural equation modeling , overall symptoms ( latent variable for pain , fatigue , and depression ) decreased significantly at T3 ( P < 0.04 ) for the class exercise group compared with the control group . There were significant interaction effects of time and group for the functional measures of walk time and grip strength : the treatment groups improved more than the control group ( P < or= 0.005 ) . There were no significant increases in measures of disease activity . Fatigue and perceptions of benefits and barriers to exercise affected participants ' amount of exercise , supporting previous research . CONCLUSION This study supported the positive effects of exercise on walk time and grip strength , and demonstrated that fatigue and perceived benefits /barriers to exercise influenced exercise participation . Furthermore , overall symptoms of fatigue , pain , and depression were positively influenced in this selective group of patients with RA ages 40 - 70 years OBJECTIVE Abnormalities of the biological stress response ( hypothalamic-pituitary-adrenal axis and the autonomic nervous system ) have been identified in both fibromyalgia ( FM ) and chronic fatigue syndrome ( CFS ) . Although these changes have been considered to be partly responsible for symptom expression , we examine an alternative hypothesis that these HPA and autonomic changes can be found in subsets of healthy individuals in the general population who may be at risk of developing these conditions . Exposure to " stressors " ( e.g. , infections , trauma , etc . ) may lead to symptom expression ( pain , fatigue , and other somatic symptoms ) in part by precipitating lifestyle changes . In particular , we focus on the effect of deprivation of routine aerobic exercise on the development of somatic symptoms . METHODS Eighteen regularly exercising ( > /=4 h/week ) asymptomatic , healthy adults refrained from physical activity for 1 week . We predicted that a subset of these individuals would develop symptoms of FM/CFS with exercise deprivation , and this manuscript focuses on the baseline HPA axis , immune , and autonomic function measures that may predict the development of symptoms . RESULTS Eight of the subjects reported a 10 % increase in one or more symptoms ( pain , fatigue , mood ) after 1 week of exercise deprivation . These symptomatic subjects had lower HPA axis ( baseline cortisol prior to VO2max testing ) , immune ( NK cell responsiveness to venipuncture ) , and autonomic function ( measured by heart rate variability ) at baseline ( prior to cessation of exercise ) when compared to the subjects who did not develop symptoms . CONCLUSIONS A subset of subjects developed symptoms of pain , fatigue , or mood changes after exercise deprivation . This cohort was different from the individuals who did not develop symptoms in baseline measures of HPA axis , immune , and autonomic function . We speculate that a subset of healthy individuals who have hypoactive function of the biological stress response systems unknowingly exercise regularly to augment the function of these systems and thus suppress symptoms . These individuals may be at risk for developing chronic multisymptom illnesses ( CMIs ) ( e.g. , FM or CFS among others ) when a " stressor " leads to lifestyle changes that disrupt regular exercise OBJECTIVES And rogen deficiency has been associated with the development of systemic lupus erythematosus ( SLE ) . The aim of this study was to test the efficacy of testosterone patches vs placebo in female SLE patients with baseline mild-to-moderate disease activity in a r and omized , double-blind , single-centre placebo-controlled trial . METHODS Patients received testosterone ( 150 microg ) or placebo transdermal patches for 12 weeks . Patients were assessed at 4-weekly intervals for disease activity using the Safety of Oestrogens in Lupus Erythematosus National Assessment -SLE Disease Activity Index ( SELENA-SLEDAI ) , Systemic Lupus Activity Measure-Revised ( SLAM-R ) and The British Isles Lupus Assessment Group ( BILAG ) indices , physician global assessment ( PGA ) , quality of life using the SF-36 survey and sexual functioning using the Derogatis score . Data were analysed using two sample t-tests to compare the mean difference from baseline to week 12 in the testosterone patch and placebo groups . RESULTS Thirty-four patients were recruited in to each group . There was no significant baseline difference between the groups in age , race or marital status . There was no significant difference between treatment groups in the mean change in SELENA-SLEDAI ( 0.547 + /- 3.72 , P > 0.60 ) , nor in PGA or BILAG system scores . The mean change in SLAM-R score was statistically different ( 2.06 , S.D. 3.3 , P = 0.01 ) but was not considered clinical ly meaningful . Health transition also showed a small change ( P < 0.03 ) . There was no significant difference in the Derogatis scores or toxicity . CONCLUSIONS Testosterone patches were safe but did not significantly affect disease activity , quality of life or sexual functioning . Increased use of steroids in the placebo group may have confounded the study results Background No previous studies have examined the effect of intensive exercise in systemic sclerosis patients with pulmonary impairment . The objective of this study was to examine the effect of an eight-week intensive aerobic exercise and muscle endurance training program for patients with systemic sclerosis with 50–100 % of forced vital capacity . Methods A single-subject experimental design with repeated systematic measures during a six week A-phase ( non-interventional baseline period ) and an eight week B-phase ( exercise intervention period ) was used . Three women and one man with median age 66 years and median disease duration of 3.5 years completed aerobic exercise corresponding to 15 on the Borg RPE scale ( strenuous ) and muscular endurance training three times/week . Physical capacity ( six-minute walk test ) , aerobic capacity ( submaximal treadmill test ) and muscle endurance in shoulder and hip flexion ( Functional Index 2 ) were assessed every other week throughout the 14-week study . Activity limitation ( Health Assessment Question naire ) , quality of life ( Short Form 36 ) , Raynaud , Fatigue and Global Health during the recent week ( Visual Analogue Scales ) were assessed at weeks 0 , 6 , 14 . Results Three participants improved significantly in muscular endurance , and two participants improved significantly or clinical ly relevant in aerobic capacity . All other variables remained unchanged , except for a trend towards reduced fatigue . Conclusions This eight week exercise program was largely successful with positive effects on aerobic capacity and muscle endurance . Trial registration Clinical trials.gov Identifier : OBJECTIVE To prospect ively identify factors influencing quality of life ( QOL ) over 6 months in patients with systemic lupus erythematosus ( SLE ) . METHODS Ninety ethnically diverse patients with SLE completed question naires administered 6 months apart assessing QOL ( using the Medical Outcomes Study Short Form-36 ) and demographic , socioeconomic , psychosocial , and behavioral factors . Disease activity , damage , and treatment were recorded at both evaluations . Multiple linear regression ( adjusting for baseline health status ) was used to identify factors influencing mental and physical health . RESULTS Improved physical health after 6 months was associated with reductions in learned helplessness ( p = 0.034 ) , improved mental health ( p<0.001 ) , longer disease duration ( p = 0.009 ) , and better physical health at baseline ( p = 0.027 ) . Improved mental health after 6 months was associated with better family support ( p = 0.002 ) , improvements in physical health ( p<0.001 ) , disease activity , and prednisolone dose ( interaction term p = 0.019 ) , less disease related damage ( p<0.001 ) , non-use of cytotoxic drugs ( p = 0.02 ) , and older age at diagnosis ( p = 0.007 ) . CONCLUSION Potentially modifiable psychosocial , disease , and therapy related factors influence QOL in patients with SLE BACKGROUND Uraemic restless legs syndrome ( RLS ) affects a significant proportion of patients receiving haemodialysis ( HD ) therapy .  Exercise training has been shown to improve RLS symptoms in uraemic RLS patients ; however , the mechanism of exercise-induced changes in RLS severity is still unknown . The aim of the current r and omized controlled exercise trial was to investigate whether the reduction of RLS severity , often seen after training , is due to expected systemic exercise adaptations or it is mainly due to the relief that leg movements confer during exercise training on a cycle ergometer . This is the first r and omized controlled exercise study in uraemic RLS patients . METHODS Twenty-four RLS HD patients were r and omly assigned to two groups : the progressive exercise training group ( n = 12 ) and the control exercise with no resistance group ( n = 12 ) . The exercise session in both groups included intradialytic cycling for 45 min at 50 rpm . However , only in the progressive exercise training group was resistance applied , at 60 - 65 % of maximum exercise capacity , which was reassessed every 4 weeks to account for the patients ' improvement . The severity of RLS symptoms was evaluated using the IRLSSG severity scale , functional capacity by a battery of tests , while sleep quality , depression levels and daily sleepiness status were assessed via vali date d question naires , before and after the intervention period . RESULTS All patients completed the  exercise programme  with no adverse effects . RLS symptom severity declined by 58 % ( P = 0.003 ) in the progressive exercise training group , while a no statistically significant decline was observed in the control group ( 17 % change , P = 0.124 ) . Exercise training was also effective in terms of improving functional capacity ( P = 0.04 ) , sleep quality ( P = 0.038 ) and depression score ( P = 0.000 ) in HD patients , while no significant changes were observed in the control group . After 6 months of the intervention , RLS severity ( P = 0.017 ) , depression score ( P = 0.002 ) and daily sleepiness status ( P = 0.05 ) appeared to be significantly better in the progressive exercise group compared with the control group . CONCLUSION A 6-month intradialytic progressive exercise training programme appears to be a safe and effective approach in reducing RLS symptom severity in HD patients . It seems that exercise-induced adaptations to the whole body are mostly responsible for the reduction in RLS severity score , since the exercise with no applied resistance protocol failed to improve the RLS severity status of the patients PURPOSE Multiple sclerosis ( MS ) is a chronic progressive autoimmune disease impacting both body and mind . Typically , patients with MS report fatigue , depression , and paresthesia .  St and ard treatment consists of immune modulatory medication , though there is growing evidence that exercising programs have a positive influence on fatigue and psychological symptoms such as depression . We tested the hypothesis that , in addition to the st and ard immune regulatory medication , either yoga or aquatic exercise can ameliorate both fatigue and depression , and we examined whether these interventions also influence paresthesia compared with a nonexercise control condition . METHODS Fifty-four women with MS ( mean age : M = 33.94 yr , SD = 6.92 ) were r and omly assigned to one of the following conditions : yoga , aquatic exercise , or nonexercise control . Their existing immune modulatory therapy remained unchanged . Participants completed question naires covering symptoms of fatigue , depression , and paresthesia , both at baseline and on completion of the study 8 wk later . RESULTS Compared with the nonexercise control condition and over time , fatigue , depression , and paresthesia decreased significantly in the yoga and aquatic exercise groups . On study completion , the likelihood of reporting moderate to severe depression was 35-fold higher in the nonexercise control condition than in the intervention conditions ( yoga and aquatic exercising values collapsed ) . CONCLUSION The pattern of results suggests that for females with MS and treated with st and ard immune regulatory medication , exercise training programs such as yoga and aquatic exercising positively impact on core symptoms of MS , namely , fatigue , depression , and paresthesia .  Exercise training programs should be considered in the future as possible complements to st and ard treatments
The subgroup analysis indicated that 12 weeks of exercise training and exercise under a supervised setting significantly benefited fatigue .
Linking Evidence to Action : The pooled data indicate that 12 weeks of an aerobic exercise program that is supervised by health professionals could reduce fatigue and increase vitality for patients with SLE .
Background : Fatigue is the most common and unpleasant symptom of patients with systemic lupus erythematosus ( SLE ) .
However , there is limited information regarding how exercise affects fatigue .
Aims : The purpose of this study is to review and synthesize the current knowledge concerning the effectiveness of exercise training for treating fatigue  among adults with SLE .
The characteristics of beneficial exercise training are further evaluated .