Skip to main content
Top
Published in: BMC Musculoskeletal Disorders 1/2013

Open Access 01-12-2013 | Research article

Low dynamic muscle strength and its associations with fatigue, functional performance, and quality of life in premenopausal patients with systemic lupus erythematosus and low disease activity: a case–control study

Authors: Sandor Balsamo, Licia Maria Henrique da Mota, Jozélio Freire de Carvalho, Dahan da Cunha Nascimento, Ramires Alsamir Tibana, Frederico Santos de Santana, Ricardo Lima Moreno, Bruno Gualano, Leopoldo dos Santos-Neto

Published in: BMC Musculoskeletal Disorders | Issue 1/2013

Login to get access

Abstract

Background

The purpose of the present study was to compare dynamic muscle strength, functional performance, fatigue, and quality of life in premenopausal systemic lupus erythematosus (SLE) patients with low disease activity versus matched-healthy controls and to determine the association of dynamic muscle strength with fatigue, functional performance, and quality of life in SLE patients.

Methods

We evaluated premenopausal (18–45 years) SLE patients with low disease activity (Systemic lupus erythematosus disease activity index [SLEDAI]: mean 1.5 ± 1.2). The control (n = 25) and patient (n = 25) groups were matched by age, physical characteristics, and the level of physical activities in daily life (International Physical Activity Questionnaire IPAQ). Both groups had not participated in regular exercise programs for at least six months prior to the study. Dynamic muscle strength was assessed by one-repetition maximum (1-RM) tests. Functional performance was assessed by the Timed Up and Go (TUG), in 30-s test a chair stand and arm curl using a 2-kg dumbbell and balance test, handgrip strength and a sit-and-reach flexibility test. Quality of life (SF-36) and fatigue were also measured.

Results

The SLE patients showed significantly lower dynamic muscle strength in all exercises (leg press 25.63%, leg extension 11.19%, leg curl 15.71%, chest press 18.33%, lat pulldown 13.56%, 1-RM total load 18.12%, P < 0.001-0.02) compared to the controls. The SLE patients also had lower functional performance, greater fatigue and poorer quality of life. In addition, fatigue, SF-36 and functional performance accounted for 52% of the variance in dynamic muscle strength in the SLE patients.

Conclusions

Premenopausal SLE patients with low disease activity showed lower dynamic muscle strength, along with increased fatigue, reduced functional performance, and poorer quality of life when compared to matched controls.
Literature
1.
go back to reference Krupp LB, LaRocca NG, Muir J, Steinberg AD: A study of fatigue in systemic lupus erythematosus. J Rheumatol. 1990, 17: 1450-1452.PubMed Krupp LB, LaRocca NG, Muir J, Steinberg AD: A study of fatigue in systemic lupus erythematosus. J Rheumatol. 1990, 17: 1450-1452.PubMed
2.
go back to reference Balsamo S, Santos-Neto LD: Fatigue in systemic lupus erythematosus: an association with reduced physical fitness. Autoimmun Rev. 2011, 10: 514-518. 10.1016/j.autrev.2011.03.005.CrossRefPubMed Balsamo S, Santos-Neto LD: Fatigue in systemic lupus erythematosus: an association with reduced physical fitness. Autoimmun Rev. 2011, 10: 514-518. 10.1016/j.autrev.2011.03.005.CrossRefPubMed
3.
go back to reference Wijndaele K, Duvigneaud N, Matton L, Duquet W, Thomis M, Beunen G, et al.: Muscular strength, aerobic fitness, and metabolic syndrome risk in Flemish adults. Med Sci Sports Exerc. 2007, 39: 233-240. 10.1249/01.mss.0000247003.32589.a6.CrossRefPubMed Wijndaele K, Duvigneaud N, Matton L, Duquet W, Thomis M, Beunen G, et al.: Muscular strength, aerobic fitness, and metabolic syndrome risk in Flemish adults. Med Sci Sports Exerc. 2007, 39: 233-240. 10.1249/01.mss.0000247003.32589.a6.CrossRefPubMed
4.
go back to reference Gale CR, Martyn CN, Cooper C, Sayer AA: Grip strength, body composition, and mortality. Int. J. Epidemiol. 2007, 36: 228-235. 10.1093/ije/dyl224.CrossRefPubMed Gale CR, Martyn CN, Cooper C, Sayer AA: Grip strength, body composition, and mortality. Int. J. Epidemiol. 2007, 36: 228-235. 10.1093/ije/dyl224.CrossRefPubMed
5.
go back to reference Ruiz JR, Sui X, Lobelo F, Morrow JR, Jackson AW, Sjostrom M, et al.: Association between muscular strength and mortality in men: prospective cohort study. BMJ. 2008, 337: a439-10.1136/bmj.a439.CrossRefPubMedPubMedCentral Ruiz JR, Sui X, Lobelo F, Morrow JR, Jackson AW, Sjostrom M, et al.: Association between muscular strength and mortality in men: prospective cohort study. BMJ. 2008, 337: a439-10.1136/bmj.a439.CrossRefPubMedPubMedCentral
6.
go back to reference Sasaki H, Kasagi F, Yamada M, Fujita S: Grip strength predicts cause-specific mortality in middle-aged and elderly persons. Am J Med. 2007, 120: 337-342. 10.1016/j.amjmed.2006.04.018.CrossRefPubMed Sasaki H, Kasagi F, Yamada M, Fujita S: Grip strength predicts cause-specific mortality in middle-aged and elderly persons. Am J Med. 2007, 120: 337-342. 10.1016/j.amjmed.2006.04.018.CrossRefPubMed
7.
go back to reference Tench C, Bentley D, Vleck V, McCurdie I, White P, D'Cruz D: Aerobic fitness, fatigue, and physical disability in systemic lupus erythematosus. J Rheumatol. 2002, 29: 474-481.PubMed Tench C, Bentley D, Vleck V, McCurdie I, White P, D'Cruz D: Aerobic fitness, fatigue, and physical disability in systemic lupus erythematosus. J Rheumatol. 2002, 29: 474-481.PubMed
8.
go back to reference Stockton KA, Kandiah DA, Paratz JD, Bennell KL: Fatigue, muscle strength and vitamin D status in women with systemic lupus erythematosus compared to healthy controls. Lupus. 2011 Stockton KA, Kandiah DA, Paratz JD, Bennell KL: Fatigue, muscle strength and vitamin D status in women with systemic lupus erythematosus compared to healthy controls. Lupus. 2011
9.
go back to reference Aparicio VA, Ortega FB, Heredia JM, Carbonell-Baeza A, Sjostrom M, Delgado-Fernandez M: Handgrip strength test as a complementary tool in the assessment of fibromyalgia severity in women. Arch Phys Med Rehabil. 2011, 92: 83-88. 10.1016/j.apmr.2010.09.010.CrossRefPubMed Aparicio VA, Ortega FB, Heredia JM, Carbonell-Baeza A, Sjostrom M, Delgado-Fernandez M: Handgrip strength test as a complementary tool in the assessment of fibromyalgia severity in women. Arch Phys Med Rehabil. 2011, 92: 83-88. 10.1016/j.apmr.2010.09.010.CrossRefPubMed
10.
go back to reference Valkeinen H, Hakkinen A, Alen M, Hannonen P, Kukkonen-Harjula K, Hakkinen K: Physical fitness in postmenopausal women with fibromyalgia. Int J Sports Med. 2008, 29: 408-413. 10.1055/s-2007-965818.CrossRefPubMed Valkeinen H, Hakkinen A, Alen M, Hannonen P, Kukkonen-Harjula K, Hakkinen K: Physical fitness in postmenopausal women with fibromyalgia. Int J Sports Med. 2008, 29: 408-413. 10.1055/s-2007-965818.CrossRefPubMed
11.
go back to reference Oliveira RJ, Bottaro M, Junior JT, Farinatti PT, Bezerra LA, Lima RM: Identification of sarcopenic obesity in postmenopausal women: a cutoff proposal. Braz J Med Biol Res. 2011, 44: 1171-1176. 10.1590/S0100-879X2011007500135.CrossRefPubMed Oliveira RJ, Bottaro M, Junior JT, Farinatti PT, Bezerra LA, Lima RM: Identification of sarcopenic obesity in postmenopausal women: a cutoff proposal. Braz J Med Biol Res. 2011, 44: 1171-1176. 10.1590/S0100-879X2011007500135.CrossRefPubMed
12.
go back to reference Ostbye T, Taylor DH, Krause KM, van Scoyoc L: The role of smoking and other modifiable lifestyle risk factors in maintaining and restoring lower body mobility in middle-aged and older Americans: results from the HRS and AHEAD. Health and Retirement Study. Asset and Health Dynamics Among the Oldest Old. J Am Geriatr Soc. 2002, 50: 691-699. 10.1046/j.1532-5415.2002.50164.x.CrossRefPubMed Ostbye T, Taylor DH, Krause KM, van Scoyoc L: The role of smoking and other modifiable lifestyle risk factors in maintaining and restoring lower body mobility in middle-aged and older Americans: results from the HRS and AHEAD. Health and Retirement Study. Asset and Health Dynamics Among the Oldest Old. J Am Geriatr Soc. 2002, 50: 691-699. 10.1046/j.1532-5415.2002.50164.x.CrossRefPubMed
14.
go back to reference Evangelista LS, Moser DK, Westlake C, Pike N, Ter-Galstanyan A, Dracup K: Correlates of fatigue in patients with heart failure. Prog Cardiovasc Nurs. 2008, 23: 12-17.CrossRefPubMedPubMedCentral Evangelista LS, Moser DK, Westlake C, Pike N, Ter-Galstanyan A, Dracup K: Correlates of fatigue in patients with heart failure. Prog Cardiovasc Nurs. 2008, 23: 12-17.CrossRefPubMedPubMedCentral
15.
go back to reference Keyser RE, Rus V, Cade WT, Kalappa N, Flores RH, Handwerger BS: Evidence for aerobic insufficiency in women with systemic Lupus erythematosus. Arthritis Rheum. 2003, 49: 16-22. 10.1002/art.10926.CrossRefPubMed Keyser RE, Rus V, Cade WT, Kalappa N, Flores RH, Handwerger BS: Evidence for aerobic insufficiency in women with systemic Lupus erythematosus. Arthritis Rheum. 2003, 49: 16-22. 10.1002/art.10926.CrossRefPubMed
16.
go back to reference Bombardier C, Gladman DD, Urowitz MB, Caron D, Chang CH: Derivation of the SLEDAI. A disease activity index for lupus patients. The Committee on Prognosis Studies in SLE. Arthritis Rheum. 1992, 35: 630-640. 10.1002/art.1780350606.CrossRefPubMed Bombardier C, Gladman DD, Urowitz MB, Caron D, Chang CH: Derivation of the SLEDAI. A disease activity index for lupus patients. The Committee on Prognosis Studies in SLE. Arthritis Rheum. 1992, 35: 630-640. 10.1002/art.1780350606.CrossRefPubMed
17.
go back to reference Cook RJ, Gladman DD, Pericak D, Urowitz MB: Prediction of short term mortality in systemic lupus erythematosus with time dependent measures of disease activity. J Rheumatol. 2000, 27: 1892-1895.PubMed Cook RJ, Gladman DD, Pericak D, Urowitz MB: Prediction of short term mortality in systemic lupus erythematosus with time dependent measures of disease activity. J Rheumatol. 2000, 27: 1892-1895.PubMed
18.
go back to reference Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, et al.: International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003, 35: 1381-1395. 10.1249/01.MSS.0000078924.61453.FB.CrossRefPubMed Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, et al.: International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003, 35: 1381-1395. 10.1249/01.MSS.0000078924.61453.FB.CrossRefPubMed
19.
go back to reference Stoll T, Gordon C, Seifert B, Richardson K, Malik J, Bacon PA, et al.: 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. J Rheumatol. 1997, 24: 1608-1614.PubMed Stoll T, Gordon C, Seifert B, Richardson K, Malik J, Bacon PA, et al.: 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. J Rheumatol. 1997, 24: 1608-1614.PubMed
20.
go back to reference Jackson AS, Pollock ML, Ward A: Generalized equations for predicting body density of women. Med Sci Sports Exerc. 1980, 12: 175-181.PubMed Jackson AS, Pollock ML, Ward A: Generalized equations for predicting body density of women. Med Sci Sports Exerc. 1980, 12: 175-181.PubMed
21.
go back to reference Rikli RE, Jones J: The senior fitness test. Defining functional fitness parameters. Senior Fitness Test Manual. Edited by: Rikli RE, Jones J. 2001, Champaign, IL: Human Kinetics, 11-24. Rikli RE, Jones J: The senior fitness test. Defining functional fitness parameters. Senior Fitness Test Manual. Edited by: Rikli RE, Jones J. 2001, Champaign, IL: Human Kinetics, 11-24.
22.
go back to reference Heyward VH: Assessing muscular fitness. Advanced fitness assessment. Edited by: Heyward VH. 2010, Champaign, IL: Human Kinetics, 129-154. Heyward VH: Assessing muscular fitness. Advanced fitness assessment. Edited by: Heyward VH. 2010, Champaign, IL: Human Kinetics, 129-154.
23.
go back to reference Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al.: Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010, 39: 412-423. 10.1093/ageing/afq034.CrossRefPubMedPubMedCentral Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al.: Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010, 39: 412-423. 10.1093/ageing/afq034.CrossRefPubMedPubMedCentral
24.
go back to reference Toulotte C, Thevenon A, Fabre C: Effects of training and detraining on the static and dynamic balance in elderly fallers and non-fallers: a pilot study. Disabil Rehabil. 2006, 28: 125-133. 10.1080/09638280500163653.CrossRefPubMed Toulotte C, Thevenon A, Fabre C: Effects of training and detraining on the static and dynamic balance in elderly fallers and non-fallers: a pilot study. Disabil Rehabil. 2006, 28: 125-133. 10.1080/09638280500163653.CrossRefPubMed
25.
go back to reference Heyward VH: Assessing flexibility. Advanced fitness assessment. Edited by: Heyward VH. 2010, Champaign, IL: Human Kinetics, 265-282. Heyward VH: Assessing flexibility. Advanced fitness assessment. Edited by: Heyward VH. 2010, Champaign, IL: Human Kinetics, 265-282.
26.
go back to reference Kraemer WJ, Ratamess NA, Fry A, French DN: Strength testing: development and evalution on methodology. Physiological assessment of human fitness. Edited by: Maud P, Foster C. 2006, Champaign, IL: Human Kinetics, 119-150. Kraemer WJ, Ratamess NA, Fry A, French DN: Strength testing: development and evalution on methodology. Physiological assessment of human fitness. Edited by: Maud P, Foster C. 2006, Champaign, IL: Human Kinetics, 119-150.
27.
go back to reference Dourado VZ, Antunes LC, Tanni SE, de Paiva SA, Padovani CR, Godoy I: Relationship of upper-limb and thoracic muscle strength to 6-min walk distance in COPD patients. Chest. 2006, 129: 551-557. 10.1378/chest.129.3.551.CrossRefPubMed Dourado VZ, Antunes LC, Tanni SE, de Paiva SA, Padovani CR, Godoy I: Relationship of upper-limb and thoracic muscle strength to 6-min walk distance in COPD patients. Chest. 2006, 129: 551-557. 10.1378/chest.129.3.551.CrossRefPubMed
28.
go back to reference Levinger I, Goodman C, Hare DL, Jerums G, Toia D, Selig S: The reliability of the 1RM strength test for untrained middle-aged individuals. J Sci Med Sport. 2009, 12: 310-316. 10.1016/j.jsams.2007.10.007.CrossRefPubMed Levinger I, Goodman C, Hare DL, Jerums G, Toia D, Selig S: The reliability of the 1RM strength test for untrained middle-aged individuals. J Sci Med Sport. 2009, 12: 310-316. 10.1016/j.jsams.2007.10.007.CrossRefPubMed
29.
go back to reference Villareal DT, Chode S, Parimi N, Sinacore DR, Hilton T, Armamento-Villareal R, et al.: Weight loss, exercise, or both and physical function in obese older adults. N Engl J Med. 2011, 364: 1218-1229. 10.1056/NEJMoa1008234.CrossRefPubMedPubMedCentral Villareal DT, Chode S, Parimi N, Sinacore DR, Hilton T, Armamento-Villareal R, et al.: Weight loss, exercise, or both and physical function in obese older adults. N Engl J Med. 2011, 364: 1218-1229. 10.1056/NEJMoa1008234.CrossRefPubMedPubMedCentral
30.
go back to reference Balsamo S, Nascimento DD, Tibana RA, Santana FS, Mota LM, Santos-Neto LL: The quality of life of patients with lupus erythematosus influences cardiovascular capacity in 6-minute walk test. Rev Bras Reumatol. 2013, 53: 81-87. 10.1590/S0482-50042013000100008.CrossRef Balsamo S, Nascimento DD, Tibana RA, Santana FS, Mota LM, Santos-Neto LL: The quality of life of patients with lupus erythematosus influences cardiovascular capacity in 6-minute walk test. Rev Bras Reumatol. 2013, 53: 81-87. 10.1590/S0482-50042013000100008.CrossRef
31.
go back to reference Xue QL, Walston JD, Fried LP, Beamer BA: Prediction of Risk of Falling, Physical Disability, and Frailty by Rate of Decline in Grip Strength: The Women's Health and Aging Study. Arch Intern Med. 2011, 171: 1119-1121. 10.1001/archinternmed.2011.252.CrossRefPubMed Xue QL, Walston JD, Fried LP, Beamer BA: Prediction of Risk of Falling, Physical Disability, and Frailty by Rate of Decline in Grip Strength: The Women's Health and Aging Study. Arch Intern Med. 2011, 171: 1119-1121. 10.1001/archinternmed.2011.252.CrossRefPubMed
32.
go back to reference Stockton KA, Wrigley TV, Mengersen KA, Kandiah DA, Paratz JD, Bennell KL: Test-retest reliability of hand-held dynamometry and functional tests in systemic lupus erythematosus. Lupus. 2011, 20: 144-150. 10.1177/0961203310388448.CrossRefPubMed Stockton KA, Wrigley TV, Mengersen KA, Kandiah DA, Paratz JD, Bennell KL: Test-retest reliability of hand-held dynamometry and functional tests in systemic lupus erythematosus. Lupus. 2011, 20: 144-150. 10.1177/0961203310388448.CrossRefPubMed
Metadata
Title
Low dynamic muscle strength and its associations with fatigue, functional performance, and quality of life in premenopausal patients with systemic lupus erythematosus and low disease activity: a case–control study
Authors
Sandor Balsamo
Licia Maria Henrique da Mota
Jozélio Freire de Carvalho
Dahan da Cunha Nascimento
Ramires Alsamir Tibana
Frederico Santos de Santana
Ricardo Lima Moreno
Bruno Gualano
Leopoldo dos Santos-Neto
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2013
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/1471-2474-14-263

Other articles of this Issue 1/2013

BMC Musculoskeletal Disorders 1/2013 Go to the issue