Structured exercise program improves functional capacity and delays relapse in euthyroid patients with Graves’ disease

Abstract

Purpose: To evaluate short- and long-term effects of structured exercise program in euthyroid patients with Graves’ disease. Methods: The study employed a retrospective case-control design. The exercise group (n = 62) underwent 3 weeks of structured exercise program consisting of daily walking, strengthening, and stretching exercises while the control group (n = 62) participated in leisure activities. Thyroid profile, aerobic capacity, and perceived fatigue were evaluated on in-patient admission and discharge. Time to discontinuation of anti-thyroid medication after discharge and time to relapse of symptoms were determined. Results: The exercise group increased estimated peak oxygen consumption (significant group-by-time ANOVA interaction, P < 0.001), decreased serum thyroxin (P = 0.038), increased serum thyrotropin (P = 0.071), and reported less fatigue (Fisher’s exact test, p < 0.001) from admission to discharge. The anti-thyroid medication was withdrawn within 6 months of discharge in significantly greater proportion of subjects in the exercise than control group (84% vs. 18%). Conversely, the rate of relapse within 12 months of medication withdrawal was smaller in the exercise (29%) than control group (72%). Conclusions: The results suggest that structured exercise program may normalize thyroid profile, improve aerobic capacity, and reduce fatigue on the short-term basis as well as reduce the need for anti-thyroid medication on the long-term basis.Implications for RehabilitationThis retrospective study suggests that the structured exercise program is safe and beneficial for euthyroid Graves’ disease patients.The main benefits include short-term improvements in aerobic capacity and fatigue and long-term reduction in anti-thyroid medication.The prospective randomized control study is warranted to define optimal exercise protocol and validate these preliminary results.