PTOTCase-ControlCardiopulmonary physical therapy journal2023

Cardiorespiratory Insufficiency and Performance Fatigability in Women with Systemic Lupus Erythematosus.

Liana C Wooten, Sarfaraz Hasni, Jamal A Mikdashi and 1 others

PMID 36742346

WHAT IT FOUND

Women with systemic lupus erythematosus reached their fatigue threshold at very low activity levels, often below the energy cost of standing tasks or walking while playing with children.

Their reduced aerobic reserve limits the ability to sustain daily activities without exhaustion.

Key findings

01Women with SLE had significantly lower peak oxygen uptake and physiologic reserve compared to healthy controls, indicating reduced capacity to sustain exercise after fatigue onset.

02The anaerobic threshold in women with SLE occurred at 3.55 METs, meaning fatigue begins during moderate activities like sweeping or walking with children.

03Patient-reported fatigue severity was significantly associated with objective measures of cardiorespiratory impairment and performance fatigability.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The sample size was small (44 women) and recruited via convenience sampling, limiting generalizability. Physical inactivity was determined by verbal response to a single question rather than objective monitoring, so actual activity levels may have differed between groups. The study did not control for menstrual phase or oral contraceptive use, which can influence exercise performance. Some participants were on prednisone, and while doses were low, the effect of other medications on oxidative metabolism was not fully accounted for. Missing data for two subjects was replaced with group means, which may affect variance calculations.

Declared interests

The authors declared no conflicts of interest.

The easy way to misread this

Do not assume that fatigue in women with SLE is solely due to lack of exercise or deconditioning. The study found clinically significant functional aerobic impairment even in sedentary controls, suggesting a pathomechanistic contribution to cardiorespiratory dysfunction that requires specific physiological management.

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