Abstract

Abstract Patients with psoriasis do not exercise to the extent recommended for cardiovascular health, due to significant disease-specific barriers, which may augment their increased risk of CVD and metabolic syndrome. Therefore, we developed a bespoke, evidenced-based exercise programme for patients with psoriasis, hypothesizing that it may have utility in the management of psoriasis. Eight patients with psoriasis (32.5 ± 12.02 years old, BMI 26.7 ± 3.3 kg m-2) completed a 20-week physical activity intervention. The first 10 weeks of the intervention comprised two walking sessions per week. Each session was of 1h duration and led by a sports-scientist for small-groups of patients with psoriasis. The volume of exercise per session was calculated so that participants would incrementally progress to heart-healthy levels of exercise over the programme. During weeks 10–20 of the programme, participants engaged in independent activities. Warm-ups, pre-exercise stretching, and cool-downs were incorporated into each of the sports-scientist led sessions. Step counts were recorded using a Newfeel Onwalk 900 pedometer throughout the study. Measurements at pre-, mid-, and post-intervention endpoints (week 0, 10 and 20) included assessment of (i) psoriasis: Psoriasis Area and Severity (PASI); Physicians Global Assessment (PGA); (ii) quality of life: Dermatology Life Quality Index (DLQI), Short Form 36 (SF-36); and (iii) cardiometabolic disease/risk – pulse wave velocity (PWV); blood pressure (BP); body weight and BMI. In addition, cardiorespiratory fitness (CRF) was assessed by: 30-s sit-to-stand (30STS); timed up and go (TUG); single leg balance (SLB); static body-weight wall-squat (SBWS); and step count. Recruitment to the study is ongoing. We observed a significant reduction in both Psoriasis Area and Severity Index and systolic BP at the weeks 10 and 20 timepoints (P < 0.05). We also observed a statistically significant improvement in the SF-36 mental health domain between the weeks 10 and 20 timepoints (P = 0.035). The CRF statistically significantly improved across the duration of the study, with a statistically significant improvement in exercise performance, as evidenced by 30STS, TUG and pedometer step counts at week 10 (P < 0.05), SLB between baseline and week 20 (P = 0.043) and SBWS performance across all timepoints. Exercise induces health benefits, including reduced skin inflammation and systolic BP, and increased CRF, and may improve some aspects of quality of life in those with psoriasis. The impact of lifestyle on psoriasis warrants further investigation. Our data suggest that exercise could represent an adjuvant therapy in the future management of psoriasis.

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