Pediatric Rheumatology Unit, School of Medicine, University of São Paulo, São Paulo, Brazil.
Med Sci Sports Exerc. 2011 Dec;43(12):2221-3. doi: 10.1249/MSS.0b013e318223b177.
Exercise training has emerged as a potential therapeutic strategy to counteract the decline in physical function and aerobic capacity in pediatric rheumatic disease.
We report for the first time on the effects of exercise training in juvenile systemic lupus erythematosus (JSLE) and antiphospholipid syndrome (APS).
A 15-yr-old boy with JSLE and APS treated with warfarin, azathioprine, and prednisone underwent a 12-wk aerobic exercise training program to improve his physical capacity and functioning. Before and after the 12-wk exercise program, the patient was submitted to incremental cardiopulmonary tests to determine VO(2peak), peak and submaximal exercise intensity, and time to exhaustion. In addition, a 6-min square-wave test was performed for assessing metabolic parameters. Functioning was assessed by using the visual analog scale. Laboratory parameters of inflammation were also assessed at baseline and 48 h after the last training session.
All the cardiopulmonary parameters (e.g., VO(2max) = +36.0%, time to exhaustion = +67.8%, peak exercise intensity = +16.7%) and the metabolic cost of movement (e.g., energy expenditure = -28.3% to -33.3%, VO(2) = -29.3% to -33.4%) were improved. Both disease activity and cumulative damage scores did not change after the intervention, and no evidence of exercise-induced exacerbation of inflammation was observed. Visual analog scale scores were also improved according to the patients' evaluation (before intervention = 8 vs after intervention = 10), parents' evaluation (before intervention = 8 vs after intervention = 10), and physicians' evaluation (before intervention = 6 vs after intervention = 9).
This is the first evidence that a 12-wk supervised aerobic training program can be safe and effective in improving aerobic conditioning and physical function in a patient with JSLE and APS. In light of these findings, the therapeutic effects of exercise training in pediatric rheumatic diseases merit further investigations.
运动训练已成为一种潜在的治疗策略，可以抵抗儿科风湿性疾病中身体功能和有氧能力的下降。
我们首次报告了运动训练对青少年系统性红斑狼疮（JSLE）和抗磷脂综合征（APS）的影响。
一名 15 岁男孩患有 JSLE 和 APS，接受华法林、硫唑嘌呤和泼尼松治疗，他接受了为期 12 周的有氧运动训练计划，以提高他的身体能力和功能。在 12 周的运动计划前后，患者接受了递增心肺测试，以确定 VO2peak、峰值和亚最大运动强度以及力竭时间。此外，还进行了 6 分钟方波测试，以评估代谢参数。功能通过视觉模拟量表进行评估。炎症的实验室参数也在基线和最后一次训练课后 48 小时进行评估。
所有心肺参数（例如，VO2max=+36.0%，力竭时间=+67.8%，峰值运动强度=+16.7%）和运动代谢成本（例如，能量消耗=-28.3%至-33.3%，VO2=-29.3%至-33.4%）均得到改善。干预后疾病活动度和累积损伤评分均未改变，且未观察到运动引起的炎症恶化。根据患者的评估（干预前=8 分，干预后=10 分）、家长的评估（干预前=8 分，干预后=10 分）和医生的评估（干预前=6 分，干预后=9 分），视觉模拟量表评分也得到了改善。
这是第一个证据表明，为期 12 周的监督有氧运动训练计划可以安全有效地改善患有 JSLE 和 APS 的患者的有氧运动能力和身体功能。鉴于这些发现，运动训练在儿科风湿性疾病中的治疗效果值得进一步研究。
