Increasing Levels of Physical Activity Led to Improvements in Wellbeing, Psychological Health in Patients With Psoriasis

Increased physical activity led to improvements in overall wellbeing and psychological health of patients with psoriasis, according to a study published in Skin Health and Disease.¹

Following the completion of an exercise regimen, researchers reported that individuals had reduced Psoriasis Area and Severity Index (PASI) scores, improved Dermatology Life Quality Index (DLQI) scores, and more.

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Background and Methods

Previous studies have outlined the important role of physical activity with psoriatic disease, such as one from Clinical and Experimental Dermatology.² Researchers reported a significant relationship between levels of physical activity and likelihood of future cardiovasular disease, noting that greater levels of activity lowered risk.

However, the ability of patients with psoriatic disease to engage in levels of physical activity similar to that of the general population is hindered by several compounding factors, including severity of disease, sensitivity of the skin, type of treatments/therapies used, form of exercise, and type of clothing worn while exercising, for example.³

The present 20-week cohort study included participants with type 1 chronic plaque psoriasis (with/without psoriatic arthritis). Participants used accelerometers and pedometers to measure physical activity before and during the study. Researchers conducted a 10-week program featuring bi-weekly 60-minute guided walks in green spaces, aiming to reach ≥500 MET-minutes/week of activity. The last 10 weeks involved independent activities recorded by participants.

Findings

The patient cohort consisted of 16 participants (8 men and 8 women) with an average age of 39.2 years, a median body mass index of 27.1, and a variety of psoriasis severities.

Following the completion of the exercise regiment, researchers observed significant improvements in psoriasis severity, as measured by PASI scores. At week 10, PASI scores decreased significantly, with more pronounced decreases observed by week 20. 18.8% of participants achieved PASI-50 at week 10, which increased to 50% by week 20.

Physician Global Assessment scores also showed significant reduction at both week 10 and week 20, reflecting overall improvements in psoriasis severity.

Physical activity interventions also led to marked improvements in measures of cardiometabolic health, including reductions in hip circumference, waist circumference, fasting glucose levels, and systolic and diastolic blood pressure. Cardiovascular health, measured by pulse wave velocity, also improved significantly by week 20.

Functional capacity, as measured by physical performance (30-second sit-to-stand test, timed up-and-go test, and static body-weight wall squat) and daily step count, improved greatly by week 20. However, daily step count improvements did not reach statistical significance.

At week 20, researchers observed a significant reduction in DLQI scores, with a notable proportion (35.7%) of participants achieving a substantial reduction in DLQI scores. In addition, anxiety and depressions scores also demonstrated improvement, though with the latter not achieving statistical significance.

Conclusions

"Increasing [physical activity] constitutes a promising therapeutic intervention in the management of psoriasis, which may also facilitate personalised therapy regimens or targeted adjunctive therapy for patients demonstrating incomplete response to standard therapy," according to Sheppard et al.

Potential limitations of the study, as noted by researchers, include the presence of self-selection bias, use of a single experimental arm and brief intervention duration, and a lack of assessment of body composition of participants.

They recommended that this initial research may be used as a baseline for the development of physical activity guidelines for patients with psoriatic disease.

References

1. Sheppard R, Gan WK, Onambele-Pearson GL, Young HS. Increased physical activity promotes skin clearance, improves cardiovascular and psychological health, and increases functional capacity in patients with psoriasis. Skin Health Disease. August 9, 2024. https://doi.org/10.1002/ski2.426
2. Auker L, Cordingley L, Griffiths CEM, Young HS. Physical activity is important for cardiovascular health and cardiorespiratory fitness in patients with psoriasis. Clin Exp Dermatol. 2022; 47(2): 289–296. https://doi.org/10.1111/ced.14872
3. Auker L, Cordingley L, Pye SR, Griffiths C, Young H. What are the barriers to physical activity in patients with chronic plaque psoriasis? Br J Dermatol. 2020; 183(6): 1094–1102. https://doi.org/10.1111/bjd.1897