A MULTICENTRE, European randomised controlled trial has found that a structured, high-intensity exercise programme significantly reduces pain and fatigue in people living with systemic sclerosis (SSc). The study, involving 170 participants across six centres, offers some of the strongest evidence to date that targeted physical activity can provide meaningful symptomatic relief alongside usual care.
Pain and fatigue are among the most severe symptoms reported by people with SSc, often significantly limiting day-to-day function and quality of life. Pharmacological approaches remain only partly effective, and robust data on the benefits of exercise in this population have been limited. Researchers therefore evaluated whether a supervised, combined exercise programme could improve key patient-reported and functional outcomes.
Participants, most with limited cutaneous SSc, were randomly assigned to either a 12-week exercise intervention group or usual care. The intervention comprised twice-weekly sessions integrating 30 minutes of high-intensity interval training (HIIT) with 15 minutes of upper-body resistance training, delivered in addition to standard medical management. Outcomes were assessed at baseline, at the 12-week primary endpoint, and again at 24 weeks.
Pain and Fatigue Improvements in Systemic Sclerosis
At 12 weeks, the intervention group demonstrated statistically and clinically significant improvements in both primary outcomes. Fatigue scores fell by a mean 10.4 points compared with usual care, while pain scores also improved. Gains extended across multiple secondary measures: participants reported better quality of life and functional ability, and levels of depression were significantly reduced. Objective assessments showed improvements in musculoskeletal strength and endurance, as well as notable increases in cardiorespiratory fitness.
Importantly, the combined HIIT and resistance-training approach was found to be safe and well tolerated in a population frequently considered exercise-limited due to pain, vascular complications and reduced mobility. No major adverse events were reported, reinforcing the feasibility of structured, supervised programmes for this patient group.
Future Directions for Systemic Sclerosis Care
The authors conclude that a 12-week tailored exercise regimen offers a valuable non-pharmacological accompaniment to existing therapies for SSc. By addressing both physical and psychological symptoms, the intervention has the potential to meaningfully enhance quality of life. The findings are expected to inform future clinical guidelines and prompt wider integration of targeted exercise into routine SSc management.
Reference
Mitropoulos A et al. 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. 2025;11: e005946.
