María is a 42-year-old woman who silently endures the chronic autoimmune disease called systemic lupus erythematosus (hereinafter, lupus or SLE), diagnosed more than 20 years ago. Lupus has an unpredictable nature that combines moments of lethargy and activation (called flares) that give no signs or warning, and is characterized by a disproportionate autoimmune response that can affect and cause damage to different organs and systems, such as the joints. , the skin, the kidney, or the cardiovascular system. In fact, cardiovascular diseases are among the leading causes of morbidity and mortality in people with lupus.
The word “tiredness” could define María’s perception of life and her daily tasks. To Mary, spoon theory presents an excellent analogy to lupus. According to this theory, the number of spoons is assimilated to the available energy, and people with lupus would have a smaller number of spoons than other people of the same sex and age who do not suffer from the disease. Therefore, in order to cover daily chores, María has to plan in which activities to use those spoons and for which activities there is no energy available. All this, added to the passing of the years with illness, motherhood, and work activity, facilitates the chronic feeling of fatigue that María suffers from.
In this context, physical activity and exercise have long been contraindicated for people with lupus, under the false premise that exercise increases fatigue. Perhaps this has contributed to people with SLE have substantially low fitness levels compared to healthy people of the same age. But science has shown that physical exercise not only does not increase fatigue, but it reduces it consistently. We now know that physical exercise gives energy instead of taking it away. Additionally, training improves cardiorespiratory capacityreduces symptoms of depression and Improves quality of life without producing side effects or increasing disease activity.
In order to provide guidelines for action to physicians and other professionals who work to improve the health of María and millions of people with SLE globally, an international working group has developed, for the first time, a consensus document that includes Recommendations for physical activity and exercise for people with SLE, a brief summary of which is included here:
- The expected benefits of physical activity and exercise should be explained to people living with lupus.
- Physical activity is recommended for all people with SLE.
- In cases of outbreak or moderate or high disease activity, it should be assessed after a medical evaluation; In these cases, a good strategy to start could be to avoid prolonged periods of sedentary lifestyle.
- The level of physical activity should be assessed using specific questionnaires or the number of steps per day.
- Physical activity must be adapted in terms of frequency and intensity for each person, taking into account their abilities, preferences and comorbidities, with the aim of achieving long-term adherence.
- Unless otherwise indicated, all people with SLE with inactive disease or mild disease activity should gradually achieve the WHO recommendations (150-300 minutes per week of moderate-intensity physical activity, associated with strengthening activities). muscle at least two days a week).
Of course, to avoid risks during physical activity, people with SLE must take into account some specific considerations for this disease:
- In case of osteonecrosis or Jaccoud syndrome, an evaluation by a specialist (rheumatologist, orthopedist or sports doctor) should be performed before starting physical activity.
- In case of outdoor activity, special care should be taken with sun protection, and the use of clothing that protects from the cold is recommended if Raynaud’s phenomenon is present.
- Physical activities that carry a high risk of trauma should be performed with caution in people with SLE who are using anticoagulant or antiplatelet treatments.
- In the event of an acute outbreak, possible contraindications to physical activity and exercise should be reevaluated.
- During joint flare-ups, it is recommended to avoid involving inflamed joints.
It is important that all professionals involved in the management of lupus know these new physical activity recommendations to be able to offer María and other more than 70,000 people in Spain the best treatment, in which physical activity must be a central part.
GET FOUND It is the EL PAÍS SALUD space where we will talk about those aspects related to physical activity, sports and physical and mental health. Physical activity and sport are part of the culture of all civilizations and play a fundamental role in the health of society at all levels, both physical and mental, at all ages, from childhood to old age, both in men as well as women. The Physical Activity and Sports Sciences have attempted to advance scientific knowledge about the importance of movement and physical exercise on the body, as well as the processes that explain why certain adaptations, modifications or changes occur to different conditions. levels (physiological, anatomical, motor, emotional or cognitive). For all these reasons, this space seeks to find scientific explanations that substantiate and justify the beneficial reasons for physical activity and sport. Likewise, it will try to discuss and refute certain myths or false beliefs that exist in society on specific topics of physical exercise and health.
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