American Journal of Clinical Dermatology

, Volume 15, Issue 2, pp 129–135 | Cite as

Levels of Physical Activity in Patients with Severe Psoriasis: A Cross-Sectional Questionnaire Study

  • Tiago Torres
  • José Manuel Alexandre
  • Denisa Mendonça
  • Carlos Vasconcelos
  • Berta Martins Silva
  • Manuela Selores
Original Research Article



Psoriasis is a chronic inflammatory disease associated with increased cardiovascular mortality, secondary to the increased prevalence of cardiovascular risk factors and premature atherosclerosis. Physical activity is a vital component in prevention and management of cardiovascular disease. Few studies have examined the level of physical activity in psoriasis patients, using validated questionnaires or other objective assessment tools.


The aim of this study was to analyze and compare physical activity undertaken by patients with severe psoriasis and healthy controls, using the International Physical Activity Questionnaire—Short Form (IPAQ-S), a validated instrument for assessing physical activity.


Ninety patients with severe plaque-type psoriasis and 160 healthy subjects were enrolled in the present study. Physical activity was evaluated using IPAQ-S.


Psoriasis patients had reduced levels of physical activity compared with non-psoriasis patients, regardless of sex or whether the variable was continuous or categorical. The odds ratio for low-level physical activity for psoriasis patients, compared with controls, was 3.42 (95 % CI 1.47–7.91), indicating that this severe psoriasis population did not undertake recommended levels of physical activity.


Psoriasis patients exhibit decreased levels of physical activity, possibly for both psychological and physiological reasons. The lack of physical activity may contribute to the increased risk of cardiovascular disease in psoriasis patients, in addition to the intrinsic risks related to systemic inflammation and psoriasis-linked comorbidities. Regular physical activity should be encouraged in all psoriasis patients because of its beneficial effects on systemic inflammation and cardiometabolic comorbidities associated with psoriasis.


Physical Activity Psoriasis International Physical Activity Questionnaire Psoriasis Patient Dermatology Life Quality Index 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



T. Torres, J.M. Alexandre, D Mendonça, C. Vasconcelos, B. Martins Silva, and M. Selores report no conflicts of interest.

No sources of funding were used to support the writing of this manuscript.


  1. 1.
    Gudjonsson JE, Elder JT. Psoriasis: epidemiology. Clin Dermatol. 2007;25:535–46.PubMedCrossRefGoogle Scholar
  2. 2.
    Armstrong AW, Harskamp CT, Armstrong EJ. Psoriasis and the risk of diabetes mellitus: a systematic review and meta-analysis. JAMA Dermatol. 2013;149:84–91.PubMedCrossRefGoogle Scholar
  3. 3.
    Armstrong AW, Harskamp CT, Armstrong EJ. The association between psoriasis and hypertension: a systematic review and meta-analysis of observational studies. J Hypertens. 2013;31:433–42.PubMedCrossRefGoogle Scholar
  4. 4.
    Armstrong AW, Harskamp CT, Armstrong EJ. The association between psoriasis and obesity: a systematic review and meta-analysis of observational studies. Nutr Diabetes. 2012;2:e54.PubMedCentralPubMedCrossRefGoogle Scholar
  5. 5.
    Ma C, Harskamp CT, Armstrong EJ, et al. The association between psoriasis and dyslipidaemia: a systematic review. Br J Dermatol. 2013;168:486–95.PubMedCrossRefGoogle Scholar
  6. 6.
    Armstrong EJ, Harskamp CT, Armstrong AW. Psoriasis and major adverse cardiovascular events: a systematic review and meta-analysis of observational studies. J Am Heart Assoc. 2013;2:e000062.PubMedCentralPubMedCrossRefGoogle Scholar
  7. 7.
    Reich K. The concept of psoriasis as a systemic inflammation: implications for disease management. J Eur Acad Dermatol Venereol. 2012;26:3–11.PubMedCrossRefGoogle Scholar
  8. 8.
    Kimball AB, Gladman D, Gelfand JM, et al. National Psoriasis Foundation. National Psoriasis Foundation clinical consensus on psoriasis comorbidities and recommendations for screening. J Am Acad Dermatol. 2008;58:1031–42.PubMedCentralPubMedCrossRefGoogle Scholar
  9. 9.
    Gaesser GA. Exercise for prevention and treatment of cardiovascular disease, type 2 diabetes, and metabolic syndrome. Curr Diab Rep. 2007;7:14–9.PubMedCrossRefGoogle Scholar
  10. 10.
    Fogelholm M, Stallknecht B, Van Baak M. ECSS position statement: exercise and obesity. Eur J Sport Sci. 2006;6:15–24.CrossRefGoogle Scholar
  11. 11.
    Wilson PB, Bohjanen KA, Ingraham SJ, et al. Psoriasis and physical activity: a review. J Eur Acad Dermatol Venereol. 2012;26:1345–53.PubMedCrossRefGoogle Scholar
  12. 12.
    Qureshi AA, Choi HK, Setty AR, et al. Psoriasis and the risk of diabetes and hypertension: a prospective study of US female nurses. Arch Dermatol. 2009;145:379–82.PubMedCentralPubMedCrossRefGoogle Scholar
  13. 13.
    Mallbris L, Granath F, Hamsten A, et al. Psoriasis is associated with lipid abnormalities at the onset of skin disease. J Am Acad Dermatol. 2006;54:614–21.PubMedCrossRefGoogle Scholar
  14. 14.
    Demirel R, Genc A, Ucok K, et al. Do patients with mild to moderate psoriasis really have a sedentary lifestyle? Int J Dermatol. 2013;52:1129–34.PubMedCrossRefGoogle Scholar
  15. 15.
    Craig CL, Marshall AL, Sjostrom M, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35:1381–95.PubMedCrossRefGoogle Scholar
  16. 16.
    Guidelines for data processing and analysis of the International Physical Activity Questionnaire (IPAQ)—Short and Long Forms. November 2005.
  17. 17.
    Haskell WL, Lee IM, Pate RR, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007;39:1423–34.PubMedCrossRefGoogle Scholar
  18. 18.
    Ramsay B, O’Reagan M. A survey of the social and psychological effects of psoriasis. Br J Dermatol. 1988;118:195–201.PubMedCrossRefGoogle Scholar
  19. 19.
    Warren RB, Kleyn CE, Gulliver WP. Cumulative life course impairment in psoriasis: patient perception of disease-related impairment throughout the life course. Br J Dermatol. 2011;164:1–14.PubMedCrossRefGoogle Scholar
  20. 20.
    Leibowitz E, Seidman DS, Laor A, et al. Are psoriatic patients at risk of heat intolerance? Br J Dermatol. 1991;124:439–42.PubMedCrossRefGoogle Scholar
  21. 21.
    Frankel HC, Han J, Li T, et al. The association between physical activity and the risk of incident psoriasis. Arch Dermatol. 2012;148:918–24.PubMedGoogle Scholar
  22. 22.
    Nicklas BJ, Hsu FC, Brinkley TJ, et al. Exercise training and plasma C-reactive protein and interleukin-6 in elderly people. J Am Geriatr Soc. 2008;56:2045–52.PubMedCentralPubMedCrossRefGoogle Scholar
  23. 23.
    Kondo T, Kobayashi I, Murakami M. Effect of exercise on circulating adipokine levels in obese young women. Endocr J. 2006;53:189–95.PubMedCrossRefGoogle Scholar
  24. 24.
    Bouassida A, Chamari K, Zaouali M, et al. Review on leptin and adiponectin responses and adaptations to acute and chronic exercise. Br J Sports Med. 2010;44:620–30.PubMedCrossRefGoogle Scholar
  25. 25.
    Jensen P, Zachariae C, Christensen R, et al. Effect of weight loss on the severity of psoriasis: a randomized clinical study. JAMA Dermatol. 2013;149:795–801.PubMedCrossRefGoogle Scholar
  26. 26.
    Hossler EW, Wood GC, Still CD, et al. The effect of weight loss surgery on the severity of psoriasis. Br J Dermatol. 2013;168:660–1.PubMedCrossRefGoogle Scholar
  27. 27.
    Roongpisuthipong W, Pongpudpunth M, Roongpisuthipong C, et al. The effect of weight loss in obese patients with chronic stable plaque-type psoriasis. Dermatol Res Pract. 2013;2013:795932.PubMedCentralPubMedGoogle Scholar
  28. 28.
    Lee PH, Macfarlane DJ, Lam TH, et al. Validity of the International Physical Activity Questionnaire Short Form (IPAQ-SF): a systematic review. Int J Behav Nutr Phys Act. 2011;8:115.PubMedCentralPubMedCrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Tiago Torres
    • 1
    • 2
    • 3
  • José Manuel Alexandre
    • 2
  • Denisa Mendonça
    • 4
  • Carlos Vasconcelos
    • 2
    • 5
  • Berta Martins Silva
    • 3
    • 6
  • Manuela Selores
    • 1
    • 2
  1. 1.Serviço de DermatologiaCentro Hospitalar do PortoPortoPortugal
  2. 2.Instituto de Ciências Biomédicas Abel SalazarUniversity of PortoPortoPortugal
  3. 3.Unit for Multidisciplinary Investigation in Biomedicine, Instituto de Ciências Biomédicas Abel SalazarUniversity of PortoPortoPortugal
  4. 4.Department of Population Studies, Instituto de Ciências Biomédicas Abel SalazarUniversity of PortoPortoPortugal
  5. 5.Department of Clinical ImmunologyCentro Hospitalar do PortoPortoPortugal
  6. 6.Immunogenetics Laboratory, Instituto Ciências Biomédicas Abel SalazarUniversity of PortoPortoPortugal

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