Background: Exercise performance has been so far investigated in small series of Systemic Sclerosis (SSc) patients.(1-3).
Objectives: To investigate exercise performance in non selected patients with SSc.
Methods: 46 patients with SSc, all of whom satisfying ACR classification criteria for the disease and consecutively admitted to a tertiary Rheumatology Unit were investigated for exercise performance as evaluated by maximal oxygen consumption (VO2 max), clinical (limited cutaneous form [lSSc] - or diffuse cutaneous form [dSSc] ), serological subset (ACA positive and anti-Scl-70 positive), severity of organ involvement as evaluated by Medsger’s severity scale and “Health Assessment Questionnaire-Disability Index” (HAQ-DI).
Results: Of the 46 patients (33 lSSc, 13 dSSc) investigated, 43 had reduced exercise performance ( Vo2max < 80% of the predicted value). Vo2max resulted to be correlated to the severity of skin (p =0,02), heart (p =0,002), pulmonary (p =0,019) involvement and HAQ–DI (p=0,008).

Conclusion: Exercise performance is impaired in most SSc patients, at least in those admitted in a referral clinic. The impairment of exercise performance is correlated to lung, heart and skin involvement and is impaired when HAQ-DI is increased.
References: 1.Schwaiblmair M et al,Cardiorespiratory responses to incremental exercise in patients with systemic sclerosis. Chest 1996; 110:1520-5
2.Sudduth CD et al,Strange C, Cook WR, Millers KS, Bowmann M, Conlop NA, et al. Failure of the circulatory system limits exercise performance in patients with systemic sclerosis Am J Med 1993; 95:413-8
3.Morelli S et al,Pulmonary hypertension is associated with impaired exercise performance in patients with systemic sclerosis.Scand J Rheumatol 2000; 29: 236-42