International Task Force Issues Physical Activity and Exercise Recommendations for People with Systemic Lupus Erythematosus

Incorporating physical activity and exercise can help improve health outcomes and quality of life for people living with systemic lupus erythematosus (SLE). Recently, an international task force provided the first set of recommendations for physical activity that provide an evidence-based approach to enhancing the well-being of people with SLE. 

The task force, consisting of experts from various disciplines (rheumatology, internal medicine, rehabilitation medicine, physiotherapy, exercise physiology and sport sciences) with specific interest and knowledge in lupus and physical activity, as well as two people with SLE conducted a research review. Based on their findings, the group agreed on three overarching principles and 15 recommendations to guide the implementation of exercise and physical activity in SLE: 

1. For people with osteonecrosis (condition that causes bone cells to die due to lack of blood supply) or Jaccoud’s syndrome (joint disorder caused by inflammation that may occur after repeated bouts of arthritis), an evaluation by a specialist should be performed before starting physical activity
2. When outdoors, use sun protection and wear adequate clothing when cold if Raynaud’s Phenomenon is present
3. Physical activities at high risk of trauma should be performed with caution when people with SLE are using anticoagulants or antiaggregant (antiplatelet drug used to avoid blood clots) treatments
4. In case of lupus flare, exercise caution and potential contraindication to physical activity and exercise should be reassessed
5. During joint-related flares, avoid physical activity and exercises involving the inflamed joints
6. Physical activity is recommended for all people with SLE
7. A person’s baseline level of physical activity should be assessed using validated questionnaires or measures
8. Physical activity should be adapted in terms of frequency and intensity on an individual basis, taking into account a person’s abilities, preferences, and comorbidities to optimize adherence and ensure physical activity over time
9. All people with inactive SLE or mild disease activity should follow the World Health Organization’s physical activity recommendations for the general population
10. A medical evaluation should be performed before starting exercise in SLE to confirm the absence of any contraindications and to ensure the safety and suitability of physical activity for the individual
11. Exercise programs should be supervised by qualified professionals for personalization
12. Implementation of exercise should be gradual by adapting the frequency and intensity to the person’s capabilities and comorbidities
13. Exercise sessions should begin with a warm-up at low to moderate intensity and should conclude with a cooling down period that includes stretching
14. Exercise programs should include both aerobic and resistance training exercises and should be performed in 3–5 sessions per week
15. Resistance training should be performed for 1–3 sets per exercise with 8–12 repetitions with 1–3 minute rest periods

These statements taken together ensure people living with SLE can safely engage in physical activity that suits individual abilities and that may improve their general health. These tailored and specific recommendations take into account the fluctuating nature of SLE so that healthcare professionals can empower their patients to live active and healthy lives with the disease. Learn more about staying active when you have lupus.

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