Recommendations for Physical Medicine and Rehabilitation to Improve Systemic Lupus Erythematosus Related Sarcopenia: A Literature Review

Abstract

Background: Systemic lupus erythematosus (SLE) is currently the most prevalent auto-immune disorder worldwide. A previous study reported the frequency of sarcopenia in patients with chronic inflammation and found a higher rate of sarcopenia in patients with SLE than in control. A preview study found that exercises management given to SLE patients can reduce fatigue and in-crease vitality Objective: The objective of this study is to understand the relationship between sarcopenia and SLE from Physical Medicine and Rehabilitation (PM&R) standpoint and its intervention. Method: Using the PubMed computer-aided search engine specific keywords: “sarcopenia” AND “Systemic lupus erythematosus” OR “lupus” OR “SLE” OR “physical medicine and rehabilitation” OR “rehabilitation” OR “physical therapy” OR “exercises” OR “physical activity” OR “training” OR “nutrition” OR “OR “diet.” Result: Exercise rehabilitation can increase energy level, cardiovascular fitness, functional status, and physical capabilities of muscle strength and are safe to be performed by patients with SLE. Re-sistance training has been shown to improve muscle strength and size, increase mitochondrial con-tent, and reduce oxidative stress. Resistance exercise impacts sarcopenia through several mecha-nisms in the muscular and neuromotor levels. Aerobic exercises are also beneficial for skeletal mus-cles to increase mitochondrial bioenergy, improve insulin sensitivity, and reduce oxidative stresses. Nutritional interventions such as protein, amino acids, essential fatty acids, and vitamin D produce biological effects that will enhance the physiological adaptation of exercise. Conclusion: Intervention for maintaining muscle function in the prevention and management of sarcopenia in SLE and its complications is a combination of resistance training and nutritional in-take through adequate protein intake.