Low Impact Aerobic Exercise Reduces Fatigue In Auto-immune Conditions 
Says Multi-study Review

Low impact aerobic exercise, such as walking and cycling, can 
effectively reduce fatigue in adults with chronic auto-immune 
conditions, according to a research review in the latest issue of the 
UK-based Journal of Advanced Nursing.

A team led by nurse researcher Dr Jane Neill from Flinders University 
in Adelaide, examined 162 research studies published between 1987 and 
2006, analysing 36 in detail.

They discovered that there was evidence that people with conditions 
like multiple sclerosis, rheumatoid arthritis, and systemic lupus 
erythematosus could benefit from exercise that gradually increased in 
intensity, duration and frequency.

"Fatigue is a major symptom in all three conditions and can cause a 
range of physical, psychological and social problems" says Dr Neill.

"Our review showed that aerobic exercise can significantly reduce 
fatigue and that some behavioural, nutritiona,l and physiological 
interventions are also very effective."

Studies reviewed by the team tested 38 interventions on more than 
1,700 patients. 24 resulted in statistically reduced fatigue or 
increased vitality levels.

The effective aerobic exercise programmes lasted an average of 12 
weeks, with participants exercising for 30 to 60 minutes, three times 
a week.

Group interventions involved supervised exercise classes, including 
warm up, low impact aerobic activity and strengthening or stretching 
exercises before cool down.

Home-based programmes made use of exercise bicycles, walking, 
cycling, jogging or swimming.

"There is good evidence that people experiencing fatigue from chronic 
auto-immune conditions can benefit from a range of non-medicinal 
interventions" concludes Dr Neill.

"Other effective strategies, apart from aerobic exercise, include 
health education and cognitive behavioural therapy.

"Cooling techniques and nutritional supplements such as acetyl-L-
carnitine and fish oil showed a number of benefits, but need to be 
looked at in more detail."

The authors suggest electro-magnetic field devices also warrant 
further investigation, due to promising results.

But they add that low-cost, low technology interventions that promote 
self-management of fatigue are probably more appropriate and feasible 
than those requiring specialised equipment or professional expertise.

They stress that any exercise programmes must be suitable for each 
individual and take account of issues that affect how people manage 
their conditions, like reduced mobility, pain, nausea and stress.

"Healthcare professionals should ask people about their fatigue and 
assess each person's symptoms" adds Dr Neill. "People with fatigue 
should be encouraged to design their own exercise routines based on 
awareness of their individual fatigue patterns and daily priorities, 
while group activities must take account of the changing nature of 
fatigue over time."

Previous research suggests that 70 per cent of people with multiple 
sclerosis suffer daily fatigue, 57 per cent of people with rheumatoid 
arthritis experience fatigue and 81 per cent of those with system 
lupus erythematosus find fatigue moderately to severely disabling.

"Any measures that can reduce people's fatigue and improve their 
quality of life are to be welcomed. Our review shows that some 
interventions have great potential, particularly in the short term, 
but that more research is needed to measure their long-term 
effectiveness" says Dr Neill.