Resistance exercises improve physical function in chronic Chikungunya fever patients: a randomized controlled trial.

BACKGROUND: Chikungunya fever is an arboviral disease, caused by an alphavirus, the Chikungunya virus, characterized by fever and joint pain that is generally disabling in the acute phase and may last from months to years, with the potential to evolve into chronic musculoskeletal symptoms, as polyarthralgia and arthritis, which can lead to significant impairment of physical function. The non-pharmacological treatment is very important for these patients, and resistance exercises may be one rehabilitation option.

AIM: This study aimed to evaluate the efficacy of a resistance exercise protocol on the physical function, pain, and quality of life of patients with chronic Chikungunya fever.

DESIGN: A randomized, controlled, blind trial for the evaluators.

SETTING: Clinic-school of Physical therapy.

POPULATION: Thirty-one patients with Chikungunya fever and musculoskeletal symptoms lasting more than three months, recruited from the Rheumatology outpatient clinic at Clinical Hospital, Federal University of Pernambuco (HC-UFPE).

METHODS: Patients (aged 56±10 years) were randomly assigned into one of two groups: Resistance Exercise Group (REG, n=15) or Control Group (CG, n=16). REG performed progressive resistance exercises with elastic bands (24 sessions over 12 weeks). CG only had their symptoms monitored through phone calls, maintaining the usual care treatment. Assessments were taken at baseline and after 6 and 12 weeks of the following: physical function (30-second Chair Stand Test (30-s CST), 4-step Stair Climb Power Test (4SCPT), 40-m Fast-paced Walk Test (40m FPWT), and Disabilities of the Arm, Shoulder, Hand (DASH) questionnaire); pain (VAS and painful joints count); quality of life Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36)); and Patient Global Impression of Change (PGIC) scale.

RESULTS: There was a reduction of pain (p=0.01; d=-0.83) and an improvement of 30-s CST (p=0.04; d=0.85) in REG participants after 12 weeks. There was no significant change in the domains of SF-36. Nearly 70% of trained patients reported improvement on PGIC.

CONCLUSIONS: Resistance exercises improved physical function in sitting and standing and reduced pain in patients with chronic Chikungunya fever.

CLINICAL REHABILITATION IMPACT: Resistance exercises can be considered as a treatment approach for patients with musculoskeletal disorders in the chronic stage of Chikungunya fever.