Mitropoulos, A. orcid.org/0000-0002-9453-0808, Jensen, K.Y. orcid.org/0000-0003-4232-6079, Kouidi, E. et al. (10 more authors) (2025) High-intensity interval and resistance training programme improves pain and fatigue outcomes in people with systemic sclerosis: a European multicentre randomised controlled trial. RMD Open, 11 (4). e005946. ISSN: 2056-5933
Abstract
Background
Pain and fatigue are among the most debilitating symptoms of systemic sclerosis (SSc), severely impairing quality of life (QoL). Pharmacological management is often inadequate, and evidence on exercise is limited. This study aimed to evaluate the effects of a tailored exercise programme on pain and fatigue in people with SSc (PwSSc).
Methods
This European multicentre randomised controlled trial (n=6) recruited 170 PwSSc (89% limited cutaneous SSc), randomised to an exercise intervention group (EIG) or usual care group (UCG). The EIG completed a 12-week, twice-weekly supervised programme combining 30 min of high-intensity interval training (HIIT) and 15 min of resistance training (RT), in addition to usual care. The UCG received usual care alone. Outcomes were assessed at baseline, 12 weeks (primary endpoint) and 24 weeks, with pain and fatigue as primary outcomes, and QoL, depression, functional ability, musculoskeletal strength/endurance and cardiorespiratory fitness as secondary outcomes.
Results
At 12 weeks, the mean group differences for the primary, fatigue (−10.4 (95% CI 19.4 to −1.4), p<0.05) and pain (0.48 (95% CI 0.21 to 0.76), p<0.05), secondary, depression (p<0.001), QoL and self-reported function (p<0.05) and exploratory outcomes musculoskeletal strength and endurance (p<0.01), and cardiorespiratory fitness (p<0.001) were significantly improved in EIG compared with UCG.
Conclusions
A 12-week supervised combined upper body exercise programme can improve pain, fatigue, depression, QoL, function, strength and cardiorespiratory fitness in PwSSc. HIIT combined with RT is safe for the study population and may serve as an effective non-pharmacological adjunct to pharmacotherapy to manage SSc symptoms and enhance QoL.
Trial registration number NCT05234671.
Metadata
| Item Type: | Article |
|---|---|
| Authors/Creators: |
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| Copyright, Publisher and Additional Information: | © Author(s) (or their employer(s)) 2025. Re- use permitted under CC BY- NC. No commercial re- use. https://creativecommons.org/licenses/by-nc/4.0 |
| Dates: |
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| Institution: | The University of Sheffield |
| Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) |
| Date Deposited: | 17 Nov 2025 16:40 |
| Last Modified: | 17 Nov 2025 16:40 |
| Status: | Published |
| Publisher: | BMJ |
| Refereed: | Yes |
| Identification Number: | 10.1136/rmdopen-2025-005946 |
| Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:234569 |
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Filename: e005946.full.pdf
Licence: CC-BY-NC 4.0

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