A study involving scientists from the Laboratory of Assessment and Conditioning in Rheumatology (SEAL) of HC-FMUSP (Hospital das Clínicas (HC), College of Medicine of the University of the South Pacific) and the Research Group in Applied Physiology and Nutrition, associated with the Faculty of Education in Physics and Sports Show (EEFE) from the University of the South Pacific that home physical exercises, intended for patients with rheumatic diseases, are effective and safe compared to physical programs in specialized centers, although the rate of adherence to this method is moderate.
“This research provides unprecedented and valid information to act on the care of these patients, in the context of concern about their care with restricted mobility, and reveals the need to use digital resources to broaden adherence,” Thiago Bikanha, a researcher at Jornal da USP, a specialist in physical education, told FMUSP Postdoctoral Fellow and Study Coordinator.
Rheumatic diseases known as rheumatism are a group of more than 100 diseases that affect the locomotor system, such as osteoporosis, rheumatoid arthritis, systemic lupus erythematosus, and fibromyalgia, among others.
According to the World Health Organization (WHO), more than 15 million people, including children, adults and adults, are affected by this disease that affects the joints, tendons and cartilage to the organs, bones and muscles.
With the restriction of movement measures imposed by the epidemic, part of the treatment of patients with these diseases has been compromised, while it involves physical activities, traditionally in person, and most patients are part of a group at risk of contracting COVID-19. According to Pekanha, the patients’ level of physical activity decreased during this period.
“For some reason, people resist commitment, and to be effective, we need to consider measures to improve this adherence, using new technologies, behavioral strategies, and re-educating the patient and enabling him to do the program remotely.”
The HC seal was developed in FMUSP projects targeting patients with rheumatic diseases to encourage physical exercise at home and this motivated scientists to evaluate the characteristics of major physical activity programs at home for patients with these diseases and whether these practices are effective in treatment compared to activities face to face.
The research indicates that physical exercises at home, in addition to their importance for treating disease, are effective and safe compared to personal physical programs in specialized centers, although the rate of adherence to the remote method is 50%.
A systematic review of the scientific literature with meta-analyzes covers 21 studies, with 1797 patients in total, mostly young and middle-aged adults. a Article authorized Efficacy of home physical activity interventions in patients with autoimmune rheumatic diseases: a systematic review and meta-analysis It was published in the journal Seminars in Arthritis and Rheumatism, In April of this year.
Characteristics of rheumatic diseases
The study focused on rheumatic autoimmune diseases. Physical education professional and PhD student at FMUSP, Sophia Mendes Cicowska, explains to Jornal da USP that these diseases affect joints and muscles and are associated with significant morbidity and mortality.
It is generally characterized by systemic inflammation, that is, inflammation that affects the entire body, which includes many organs and tissues, and shares common clinical characteristics such as chronic pain, fatigue and, as a result, a poor quality of life associated with health. .
To assess the effects of physical activity on these patients, the review was selected in publications from PubMed, Web of Science, Scopus, Cochrane, the CINAHL database, and Sportdiscus studies that compared home exercise status with conditions without exercise (control) and with face-facial exercises in patients with Rheumatic diseases.
“We are looking to see if home activity was effective, similar or inferior to traditional exercise in treating these patients,” says Pechanha.
According to the researcher, the study analyzed the quality of life, pain, disease activity, inflammation, and functional ability, which is the ability to perform daily tasks that the disease usually weakens, such as tying a shoelace.
When evaluating the characteristics of home physical activity programs for this population, the research showed that the duration, on average, was four months, with a routine combining flexibility and strengthening exercises, and finally adding to aerobic, postural and respiratory exercises, which were performed for a period of 40 minutes. And at low to moderate density.
“It is worth noting that two studies used mobile electronic games five times a week,” Pekanha adds.
The evaluation showed that most programs were unsupervised and that monitoring was partial, with responses to diaries, phone calls, and low use of techniques. Exercise equipment was used, along with bands, sports bikes, and weights, which researchers sent home to patients.
The results showed that home activity, compared to non-exercise, was able to improve functional ability, reduce pain, and reduce disease activity.
“This indicates that in addition to improving the traditional symptoms, it helps in controlling and treating the disease,” says Pechanha. In the comparison between home exercises and face-to-face exercises, no difference was observed. According to him, physical activity at home was as effective as physical activity, among the characteristics indicated by the research, and is the largest clinical effect of the study.
The data revealed that the adherence rate to home programs was 50%, which is considered moderate. “For some reason, people resist commitment, and to be effective, we need to think of measures to improve this commitment, using new technologies, behavioral strategies, and re-educating the patient and enabling him to do the program remotely,” he adds.
Remote intervention with the characteristics mentioned in the study was also rated as safe, while no study reported adverse effects, and for level of education, the research provides guidance on how to design and plan these interventions in the best way.
“We hope that the health professional will use the information we provided in the article to recommend practices and that the physical activity specialist will use it to design programs to serve the population,” Peçanha adds.
Researcher highlights Podcast “Nasty Exercise”, Which is a project that aims to increase the population’s knowledge of the importance of physical activity and nutrition for a comfortable health.
The program is supported by the UK Physiology Society and implemented by Rafael Fecchio, from the University of the South Pacific. Raphael Resende, from Paulista University, Aloysio Lima, from Federal de Sergipe, as well as Thiago Pisanha.