Background Fatigue and arthritis are common sources of impairment in SLE patients that persist despite lifestyle and pharmacologic interventions. Walk with Ease (WWE) is the Arthritis Foundation’s 6 week evidence-based walking program developed for adults with arthritis that has been shown to improve physical function, pain, stiffness and fatigue in individuals with arthritis. WWE is offered in two formats – group (instructor led) or self-directed. The goal of this study was to examine the feasibility of self-directed WWE in SLE patients.
Methods We enrolled 75 SLE patients to take part in the WWE program, all of whom completed an initial evaluation. The post-6 week evaluation with no usual care comparison group was conducted in 46 patients. Self-reported outcomes including symptoms (pain, stiffness and fatigue visual analog scales [VAS]) and Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-fatigue) scale were evaluated. Means and effect sizes (ES) with 95% confidence intervals were computed for changes in symptoms between baseline and 6 weeks, adjusted for gender, age, race, and baseline outcome. Participant satisfaction measures with WWE are reported as percentages.
Results Participants were mainly women (96.0%), aged ≥40 years, self-identified as black (53.3%) and 13 years from initial SLE diagnosis. Fifteen (20.0%) participants also had a physician diagnosis of OA, while 21 (28.0%) participants had concurrent fibromyalgia. Four participants were screen failures, 9 were withdrawn by the study team, 13 were lost to follow-up and 3 had not yet reached the end of the 6 week protocol. There were 46 participants who completed the WWE program; no significant differences in baseline measures were observed between those who did and did not complete the study. At the end of 6 weeks, participants reported having reduced FACIT-fatigue scores (ES=0.14), as well as having reduced scores for VAS fatigue and stiffness (ES=0.22 and 0.11, respectively [table 1]). Most participants reported walking for at least 30 minutes/day (47.7%),≥3 days/week (86.4%) and utilized the workbook for motivation (65.3%). Participants also reported increased physical activity (81.8%), confidence to continue exercising (97.8%) and satisfaction from the program (97.8%).
Conclusions WWE is a feasible, low-cost program that may decrease SLE-related fatigue and stiffness, improve activity and promote long-term lifestyle changes.
Trial registration ClinicalTrials. gov Identifier: NCT02631005.
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