The Effect of ۱۲ Weeks of Aquatic Walking Exercise on Inflammatory Markers in Patients With Systemic Lupus Erythematosus: An Interventional Study

Background and Aim: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by inflammation and the production of autoantibodies, including anti-double-stranded DNA (dsDNA), and elevated erythrocyte sedimentation rate (ESR). This study aimed to investigate the effect of ۱۲ weeks of aquatic walking exercise on the levels of C-reactive protein (CRP), ESR, anti-dsDNA, white blood cell (WBC), red blood cell (RBC), platelet count, and immature granulocytes in patients with SLE. Materials and Methods: In this quasi-experimental study, ۱۴ male patients with SLE aged ۲۰–۴۰ years were randomly assigned to two groups: intervention (aquatic walking exercise, n=۷) and control (usual care, n=۷). The intervention group consisted of ۱۲ weeks of aquatic walking, three sessions per week, lasting ۲۰–۵۰ minutes per session. Session duration was progressively increased every four weeks up to ۵۰ minutes, with exercise intensity maintained at ۴۰%–۷۰% of heart rate reserve. Inflammatory markers were measured at baseline and ۴۸ hours after the final session. To determine the significance of the variables, the non-parametric analysis of covariance (ANCOVA) test was employed. To check for data normality, the Shapiro-Wilk test was used. The results of this test indicated that the biological marker data did not follow a normal distribution (P<۰.۰۵). Therefore, statistical analyses were performed using non-parametric tests. For examining paired differences between the groups, the Mann–Whitney U post-hoc test was utilized. The P obtained from the Mann–Whitney U test were reported for each paired comparison, and the significance level was set at P=۰.۰۵. Results: After ۱۲ weeks, aquatic walking exercises significantly reduced ESR, anti-dsDNA, and white blood cell (WBC) levels compared to the control group (P<۰.۰۵). In contrast, changes in red blood cell (RBC), platelet count, and immature granulocytes were not statistically significant (P>۰.۰۵). The participants in the intervention group also reported notable improvements in pain, fatigue, and physical function. Conclusion: Aquatic walking exercise may serve as an effective therapeutic intervention to decrease anti-dsDNA and ESR levels and improve clinical symptoms, such as joint pain, inflammation, chronic fatigue, joint stiffness, sleep quality, and quality of life in patients with SLE.

کلیدواژه ها:

Walking ، Blood sedimentation ، Anti-dsDNA autoantibody ، Systemic lupus erythematosus (SLE) ، Inflammatory mediators ، Aquatic therapy