OP0117-HPR PRELIMINARY FINDINGS OF A COMBINED HIGH INTENSITY INTERVAL TRAINING (HIIT) PROGRAMME ON PAIN AND FATIGUE IN PEOPLE WITH SYSTEMIC SCLEROSIS: A MULTI-CENTRE RANDOMISED CONTROLLED TRIAL
Authors: A. Mitropoulos, C. Boström, M. Mattsson, T. Dimitroulas, A. Teloudi, T. P. M. Vliet Vlieland, J. K. De Vries-Bouwstra, G. Cuomo, L. P. Diederichsen, L. K. Winberg, K. Y. Jensen, M. Klonizakis
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Raynaud's phenomenon and digital ulceration are two of the most common disease manifestations leading to digital and/or toe pain in systemic sclerosis (SSc). In addition to pain, fatigue has been identified as a key stressor and the most prevalent and debilitating symptom of SSc. Both, significantly affect health-related quality of life (HRQoL) domains. Pharmacological therapeutic strategies have not been proved sufficiently effective in the management of SSc-induced pain and fatigue. Evidently the effectiveness of non-pharmacological interventions (e.g., exercise) is limited, although promising. <h3>Objectives:</h3> To examine the effects of HIIT on an arm crank ergometer combined with strength training on pain and fatigue, as well as HRQoL in people with SSc. <h3>Methods:</h3> This was a multicentre (n=6) research clinical trial, FOREUM-funded study (FOREUM-059)[1]. People with SSc (n=124) were allocated randomly to two groups. Group A performed the exercise programme parallel to standard care and Group B received the standard care alone. The exercise programme consisted of a 12-week combined (aerobic and resistance training) exercise protocol twice per week. The exercise protocol consisted of a 30-minute-HIIT (30s 100% peak power output/30s passive recovery) and a circuit resistance training for upper extremity of approximately 15 minutes. All participants were assessed at baseline and at three months. Pain, fatigue (Primary outcomes), and HRQoL (Secondary outcome) were assessed via questionnaires (FACIT-F, VAS-SHAQ, and SScQoL). <h3>Results:</h3> Statistically significant differences were observed at 12 weeks both between (Table 1) and within (compared to baseline) the groups for pain, fatigue and HRQoL. More specifically, the exercise group demonstrated significant improvements (baseline vs 12 weeks) in outcomes related to pain (i.e., VAS-Pain 0.67 ± 0.81 vs 0.36 ± 0.63, P&lt;0.001) and fatigue (i.e., FACIT-F total score 109.2 ± 27.5 vs 118.2 ± 28.2, P&lt;0.01), as well as HRQoL (i.e., SScQoL total score 10.0 ± 7.2 vs 8.9 ± 6.7, P&lt;0.01). In contrast, the control group showed a statistically significant decline in HRQoL and fatigue outcomes. <h3>Conclusion:</h3> Our findings demonstrate that a combined HIIT exercise programme indicate to be effective in improving pain, fatigue and HRQoL in people with SSc. To highlight, all the components of the FACIT-F questionnaire were improved in the exercise compared to the control group. Future studies should explore the wider implementation of such an exercise programme in people with SSc. <h3>REFERENCES:</h3> [1] Mitropoulos A, Boström C, Mattsson M, et al. Exploring the effects of a combined exercise programme on pain and fatigue outcomes in people with systemic sclerosis: Study protocol for a large European multi-centre randomised controlled trial. <i>Trials</i>. 2022;23(1):962. https://doi.org/10.1186/s13063-022-06853-1. doi: 10.1186/s13063-022-06853-1. <h3>Acknowledgements:</h3> We would like to thank the following contributors to our study, Dr M. Akil (STH NHS FT, Sheffield, UK) for supporting recruitment in Sheffield, UK, Prof Jacobsen S and Dr Jullie Rudnicki R.C (Copenhagen Research Centre for Autoimmune Connective Tissue Diseases, Copenhagen University, Copenhagen, Denmark) for their contribution in the study coordination and day to day management in Copenhagen, Denmark, and Prof Evangelia Kouidi (Laboratory of Sports Medicine, Department of Physical Education and Sports Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece) for supporting and co-ordinating the study in Thessaloniki. Finally, we would like to thank "The Swedish Rheumatism Association" and "Region Norrbotten" for providing funding and supporting the study in Sweden. <h3>Disclosure of Interests:</h3> <b>None declared.</b>