Physical capacity in performing daily activities is reduced in scleroderma patients with early lung involvement

Background and Aims Patients with systemic sclerosis ( SSc ) often complain reduced capacity at submaximal exercise; conversely, physical capacity in performing daily duties has never been measured in SSc . The aim of this study is to evaluate this performance and its correlates, in patients with SSc compared with healthy controls, in a free‐living setting. Methods Twenty‐seven outpatients with stable SSc and 11 controls were recruited. Physical activity was assessed by portable multiple sensor device ( S ense W ear A rmband) worn for at least 6 days. Physical activity duration ( PAD ; in minutes) for non‐sedentary activities and physical activity level ( PAL  = total daily energy/resting energy expenditure) per day were calculated. Nutritional status was estimated by bioelectrical impedance analysis and pulmonary arterial hypertension excluded by echocardiography. Results Daily physical activities (243 ± 145 min per day vs 397 ± 142 min, respectively; P  = 0.005) and PAL were significantly reduced in SSc compared with controls (1.5 ± 0.4 vs 2 ± 0.7, respectively; P  = 0.019). Seventy‐four per cent of SSc patients showed PAL  < 1.70, whereas only 27% of controls were below this threshold for sedentary life style. Both PAD and PAL positively correlated with DLco . Patients and controls did not differ for spirometric parameters, body mass index, phase angle at bioelectrical impedance analysis, fat mass or fat‐free mass indexes. In SSc , exercise capacity during daily activity was reduced compared with controls, and was associated with early evidence of functional decay (decreasing DLco ) but not with malnutrition (undernutrition). Conclusions A reduction of daily physical activity is already present even in early stages of lung involvement in SSc , characterized by unaltered spirometry and well‐preserved nutritional status.