The effects of an exercise program in sarcoidosis patients

Objective: To investigate the effects of an exercise program including breathing, aerobic and strengthening exercises on lung function, perception of dyspnea,fatique and pain, exercise capacity, muscle strength, quality of life, anxiety and depression in patients with stage 3 and 4 sarcoidosis. Method: Patients aged 35-65 who had stage 3 and 4 sarcoidosis were included in the study. Subjects were randomly divided into two groups as exercise and control group patients. Demographic features, clinical symptoms were recorded. Lung function were assessed by measuring body plethysmography and carbon monoxide diffusing capacity test and blood gases analysis. Chest circumference measurements was performed from three region to evaluate flexibility of rib cage using a tape. Dyspne was assessed by Modify Medical Research Council Dyspnea Scale and fatique was assessed by Fatiue Severity Scale and pain was assessed by Visual Analogue Scale. Respiratory muscle strength assessed by measurements of maximal inspiratory and expiratory pressures and peripheral muscle strength measured using back and leg dynamometer. Quality of life assessed using St. George Respiratory Questionnaire and Short Form-36 Quality of Life Questionnaire. Pyschological symptoms were assessed by Hospital Anxiety and Depression Questionnaire. Patients who were in exercise group underwent a 12 week supervised exercise program. Patients who were in control group underwent routine medical treatment. Results: Median age of exercise group was 59(52-64) years and it was 51(45-57) years for control group and the median durations of sarcoidosis were 11(4-4) and 6(3-14) years, respectively. In exercise group six minute walk distance, peripheral muscle strength, leg fatique, dyspnea and peripheral oxygen saturation at the end of the test improved and perception of pain, dyspnea, fatique and anxiety decreased after follow-up(p<0.05). In control group fatigue severity increased(p<0.05). Chest circumference measurements improved in exercise group(p<0.05). While symptoms were worsened in control group, all domains in disease specific quality of life scale improved in exercise group after follow-up(p<0.05). Health related quality of life scores didn't differ in both groups(p>0.05) While pulmonary function tests wasn't differ in both groups, arterial oxygen pressure and arterial oxygen saturation improved in exercise group(p<0.05). Conclusion: Exercise program that consists of breathing, aerobic and strengthening exercises improved disease symptoms, functional capacity, quality of life, anxiety and fatique in advance sarcoidosis patients. So it suggest that exercise training should take place in standart treatment of this patients. Key Words: Sarcoidosis, exercise program, exercise capacity, quality of life, dyspnea, fatique, muscle strength