Effectiveness of Resistance Exercise in women with primary Sjögren's syndrome (pSS): A randomized trial

Introduction. Primary Sjögren Syndrome (pSS) is an autoimmune inflammatory systemic disease that affects exocrine glands and less frequently internal organs. Inflammation can affect any system, including the musculoskeletal system, resulting in reduction in physical functions with consequent decrease in muscle strength, aerobic capacity, joint mobility, and static balance. In addition, psychosocial impairment with potential worsening of quality of life and functional capacity (FC) is described. Objective. Analyze the effectiveness of resistance exercise on daily motor behavior and FC in women with pSS. Methods. Fifty nine patients were randomized; of which 51 completed the study (26 assigned to the exercise group - EXG and 25 to the control group - CG). The EXG participated in a 16 week supervised exercise program, including 2 sessions per week and 3 sets of 10 maximal repetitions per exercise. Both before and at the end of the intervention protocol four variables were evaluated: the daily motor activity index (DMAI) was analyzed by an actigraph, which records body movements; the FC by the Fullerton Functional Fitness Test that consists of a sequence of 6 tests that mimic the neuromotor and cardiorespiratory needs involved in the activities of daily life; the disease activity (ESSDAI questionnaire); and quality of life (SF-36 questionnaire). Results. After the intervention period in the EXG group, all FC parameters showed improvement over basal and final times, except the upper limb (UL) flexibility test (p=0.896): UL strength (p<0.001), lower limb (LL) strength (p<0.001), LL flexibility (p=0.001), aerobic capacity (p<0.001), agility (p=0.002). A similar situation occurred with the SF-36 where all domains improved, except for the emotional aspect (p=0.710): functional capacity (p<0.001), limitation by physical aspects (p=0.005), pain (p<0.001), general condition (p=0.006), vitality (p<0.001), social aspects (p=0.001), and mental health (p<0.001). There was no change in the DMAI (p=0.2) or ESSDAI (p=0.284). In the CTRL group, the only variable that showed a difference when compared to baseline was aerobic capacity of the FC test, presenting a tendency to improve (p=0.05). Conclusion. Thirteen of the 17 variables evaluated showed improvement after the resistance exercise program. The intervention protocol did not change the daily motor behavior (DMAI), flexibility parameter of UL of the FC test, or the domain emotional aspects of the quality of life questionnaire. Resistance exercise did not worsen disease activity (ESSDAI). In this sense, we can conclude that the program that included resistance exercise was effective in improving functional capacity and quality of life in women with pSS.