de Oliveira Natália Cristina, Portes Leslie Andrews, Pettersson Henrik, Alexanderson Helene, Boström Carina
Research Group in Physical Exercise, Lifestyle and Health Promotion. Health Promotion Master Program, UNASP - Adventist University of São Paulo, São Paulo, SP, Brazil.
Unit of Rheumatology, Department of Medicine Solna, Karolinska Institutet, and, Functional Area Occupational Therapy & Physiotherapy, Allied Health Professionals Function, Karolinska University Hospital, and, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.
Musculoskeletal Care. 2017 Dec;15(4):316-323. doi: 10.1002/msc.1185. Epub 2017 Apr 5.
Patients with systemic sclerosis (SSc) experience reduced exercise capacity and muscle strength compared with healthy subjects. There are also indications of reduced levels of physical activity.
To present the current knowledge of physical exercise in SSc.
Most studies presently available [three case studies, one single subject experimental design, one study comparing patients with healthy controls, one quasi experimental design (pre-post), two clinical trials and two random controlled trials] have included small samples of patients, mostly composed of patients with and without pulmonary involvement. It seems that patients with SSc without pulmonary involvement are able to perform and benefit from aerobic exercises of at least moderate intensity. Exercise tolerance, aerobic capacity, walking distance, muscle strength and muscle function as well as health-related quality of life (HRQL) have been found to be improved after participation in programmes including aerobic exercise and aerobic exercise combined with resistance exercises. Improvements seem to be only partially retained at follow up. Patients with pulmonary involvement may also experience improved muscle strength, physical and aerobic capacity, as well as HRQL following exercise.
Patients with SSc without pulmonary involvement can be recommended to be as physically active as the general population. Patients with mild pulmonary involvement can be recommended to be physically active by engaging in exercises of moderate intensity and to participate in moderate-load resistance exercises. Health professionals should inform patients with SSc about the importance of physical activity and avoidance of a sedentary lifestyle.
与健康受试者相比，系统性硬化症（SSc）患者的运动能力和肌肉力量有所下降。也有迹象表明其身体活动水平降低。
介绍目前关于SSc患者体育锻炼的知识。
目前大多数研究[三个病例研究、一个单受试者实验设计、一项比较患者与健康对照的研究、一个准实验设计（前后对照）、两项临床试验和两项随机对照试验]纳入的患者样本量较小，大多数样本包含有和无肺部受累的患者。似乎无肺部受累的SSc患者能够进行至少中等强度的有氧运动并从中受益。参与包括有氧运动以及有氧运动与抗阻运动相结合的项目后，运动耐力、有氧能力、步行距离、肌肉力量和肌肉功能以及健康相关生活质量（HRQL）均有所改善。随访时这些改善似乎仅部分得以维持。有肺部受累的患者运动后肌肉力量、身体和有氧能力以及HRQL也可能得到改善。
对于无肺部受累的SSc患者，建议其保持与普通人群相同的身体活动水平。对于轻度肺部受累的患者，建议其通过进行中等强度的运动并参与中等负荷抗阻运动来保持身体活动。卫生专业人员应告知SSc患者身体活动的重要性以及避免久坐不动的生活方式。
