Aerobic Exercise Program Reduces Musculoskeletal Pain and Fatigue in Psoriasis Subjects without Psoriatic Arthritis

by | Dec 19, 2023 | 2023, Arthritis, Fitness and Exercise, Skin Health

Written by Taylor Woosley, Staff Writer. A 16-week aerobic exercise intervention significantly improved lipid profiles (HDL-cholesterol, p = 0.006; triglycerides, p = 0.021), mean FACIT-fatigue scores (p = 0.027), HAQ-DI scores (p = 0.034), and VAS scores (p = 0.009) in male subjects with psoriasis. 

Psoriasis (PsO) is a chronic inflammatory skin disease characterized by sharply demarcated erythematous plaques with whitish scale1. It is largely a T lymphocyte-mediated disease in which activation of innate immune cells and pathogenic T cells result in skin inflammation and hyperproliferation of keratinocytes2. PsO is associated with increased risk for comorbidities, including psoriatic arthritis, cardiovascular disease, diabetes mellitus, obesity, and inflammatory bowel disease compared with the general population3.

Studies report that up to half of patients with PsO display musculoskeletal symptoms, including joint pain, tenderness, and inflammation4. Furthermore, PsO patients suffer more from sleep disturbances, fatigue, and anxiety, which has a negative impact on their quality of life5. Exercise has been shown to improve disease outcomes and comorbidities associated with PsO and these benefits can be attributed to adipose tissue reduction and a possible decrease in oxidative stress6.

Diaz et al. conducted a randomized study to investigate the influence of an aerobic exercise intervention program on reducing fatigue and musculoskeletal pai in adult patients with PsO without psoriatic arthritis. Subject inclusion consisted of being a male between the ages of 18-45 years, with a diagnosis of mild psoriasis based on the psoriasis area severity index (PASI) and with dermatology life quality index (DLQI) scores <7, who were undergoing topical psoriasis treatment (excluding steroids in the last 3 months), with medical approval for physical activity participation.

118 participants were randomly assigned to the intervention (n=59) or control (n=59) group. Those in the intervention group partook in a 16-week aerobic exercise program using a conventional motorized treadmill three times per week. Subjects wore a wireless heart rate monitor for the sessions which featured a 10-15 minute warm up, a 35-50 minute treadmill exercise at a work intensity of 50-65% of peak heart rate, and a 5-10 minute cool down. Subjects recorded a 3-day food frequency questionnaire to control for the potential confounding effect of diet. Participants completed the Functional Assessment of Chronic Illness Therapy Fatigue Scale (FACIT-Fatigue) to assess their fatigue level and a Health Assessment Questionnaire-Disability Index (HAQ-DI) to analyze limitations regarding performing daily physical activities. Furthermore, pain intensity was assessed using a visual analog scale (VAS).

All subjects partook in a modified Bruce multistage maximal treadmill protocol at baseline and one week after the end of the study. During the protocol, blood pressure and cardiac electrical activity were continuously monitored. A gas analyzer was utilized to measure maximal oxygen consumption (VO2max). Additionally, fasted blood samples were obtained to measure plasma glucose and lipid profiles. One-step sandwich immunoassays were analyzed for creatine kinase activity and myoglobin concentration as measures of muscle damage. Body composition was measured after an overnight fast using a bioelectrical impedance analysis. Questionnaires and blood samples were completed by all subjects at baseline (week 0) and 24-hours after the last training session in week 16. Significant findings of the study are as follows:

  • Compared to baseline, the aerobic exercise group had significantly improved their maximal aerobic power (VO2max) (p = 0.020). No significant changes were noted in the control group (p = 0.286).
  • The intervention group experienced significantly improved serum lipid profiles at the end of the study (HDL-cholesterol, p = 0.006; triglycerides, p = 0.021). No significant differences were noted regarding glycemia.
  • No significant changes were noted in the aerobic exercise group regarding serum markers of muscle damage after the intervention completion. Furthermore, significant improvements in mean FACIT-fatigue scores (p = 0.027), the HAQ-DI scores (p = 0.034), and VAS scores (p = 0.009) were observed in the intervention group.

Results of the study show that a 16-week aerobic exercise intervention significantly improved musculoskeletal pain, lipid profiles, fatigue scores, and disability limitation scores in male subjects with psoriasis. Further research should continue to explore the potential health benefits of aerobic exercise on chronic inflammatory conditions. Study limitations include the short study duration, the use of solely male subjects which does not allow for generalizability of findings, and the lack of assessing the effect of the intervention on fat mass distribution.

Source: Diaz, Antonio J., Miguel A. Rosety, Jose C. Armario, Manuel J. Bandez, Natalia Garcia-Gomez, Eduardo Sanchez-Sanchez, Jara Diaz et al. “Regular Exercise Improved Fatigue and Musculoskeletal Pain in Young Adult Psoriatic Patients without Psoriatic Arthritis.” Nutrients 15, no. 21 (2023): 4563.

© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

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Posted December 19, 2023.

Taylor Woosley studied biology at Purdue University before becoming a 2016 graduate of Columbia College Chicago with a major in Writing. She currently resides in Glen Ellyn, IL.

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