Structured exercise program improves functional capacity and delays relapse in euthyroid patients with Graves' disease

Abstract

Purpose: To evaluate short- and long-term effects of structured exercise program in euthyroid patients with Graves' disease. Methods: The study employed a retrospective case-control design. The exercise group (n62) underwent 3 weeks of structured exercise program consisting of daily walking, strengthening, and stretching exercises while the control group (n62) participated in leisure activities. Thyroid profile, aerobic capacity, and perceived fatigue were evaluated on in-patient admission and discharge. Time to discontinuation of anti-thyroid medication after discharge and time to relapse of symptoms were determined. Results: The exercise group increased estimated peak oxygen consumption (significant group-by-time ANOVA interaction, P < 0.001), decreased serum thyroxin (P0.038), increased serum thyrotropin (P0.071), and reported less fatigue (Fisher's exact test, p < 0.001) from admission to discharge. The anti-thyroid medication was withdrawn within 6 months of discharge in significantly greater proportion of subjects in the exercise than control group (84% vs. 18%). Conversely, the rate of relapse within 12 months of medication withdrawal was smaller in the exercise (29%) than control group (72%). Conclusions: The results suggest that structured exercise program may normalize thyroid profile, improve aerobic capacity, and reduce fatigue on the short-term basis as well as reduce the need for anti-thyroid medication on the long-term basis. Implications for Rehabilitation This retrospective study suggests that the structured exercise program is safe and beneficial for euthyroid Graves' disease patients. The main benefits include short-term improvements in aerobic capacity and fatigue and long-term reduction in anti-thyroid medication. The prospective randomized control study is warranted to define optimal exercise protocol and validate these preliminary results. © 2012 Informa UK, Ltd.