Impact of physical rehabilitation program on quality of life in patients with acromegaly: non-randomized clinical trial

Abstract

Introduction: Acromegaly is chronic, systemic and highly disabling disease. Patients with Acromegaly patients show a significant reduction in peripheral muscle strength associated with a loss resistance and lethargy. Thus, these patients tend the fatigue more easily when compared to individuals without the disease, which involves exercise intolerance and disability resulting in a quality of life impaired. Acromegaly has important functional limitations that adversely affect the performance in the activities of day-to-day and contribute to the worsening of the disease. Based on previous studies, we believe that acromegaly patients would have benefit from a treatment protocol facing physical performance and improved quality of life. Objective: To evaluate the effect of therapist-oriented home rehabilitation (TOHR) in patients with acromegaly. Methods: In this quasi-experimental and longitudinal study, 17 participants underwent an exercise program with a 3-month booklet, 3 times a week with a duration of 60 min each session, and were re-evaluated in 3 moments: before treatment, after 8 weeks and after 1 month of washout (month 0, month 2, month 3 respectively). Participants were submitted to the following evaluations: Assessment of quality of life through Acromegaly Quality of Life Questionnaire (AcroQoL) questionnaires, body composition through bioimpedance, functional assessment using the six-minute walk test (6MWT), peripheral muscle strength through hand grip and lower limbs using isometric dynamometry. The Lower Extremity Functional Scale (LEFS) was used and the fatigue was measured by the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scale, while the balance was measured by force-platform stabilometry. The treatment protocol consisted of warm-up and cool-down, strengthening exercise and muscular endurance, aerobic training, and balance training and proprioception. Results: After TOHR, improvements were observed in general fatigue, quadriceps muscle strength, LEFS, 6MWT, balance control and all AcroQoL dimensions. After 1 month of washout, however, these gains were lost for all parameters except LEFS and balance control. Conclusion: In acromegalics, the TOHR shows improvements in muscle function, functional capacity, general fatigue, body balance and QoL. Thus, TOHR should be considered as an adjunct to hormonal control therapy, especially in patients with long-term disease.