Supervised Moderate-Intensity Combined Aerobic and Resistance Exercise Versus Conventional Physiotherapy for Statin-Associated Muscle Symptoms: An Experimental Study

Abstract

Background: Statin-associated muscle symptoms (SAMS) frequently lead to treatment discontinuation and residual cardiovascular risk. Although moderate-intensity exercise is considered safe in statin users, controlled evidence comparing progressive combined aerobic–resistance training with conventional physiotherapy remains limited.
Methods: Sixty adults (aged 40–75 years) with confirmed SAMS were allocated to Group A (supervised moderate-intensity combined aerobic and resistance exercise, n = 30) or Group B (conventional physiotherapy: light aerobic activity, static stretching and education, n = 30) in a double-group pre-post experimental design. Interventions were delivered three times weekly for eight weeks under physiotherapist supervision. Outcomes assessed at baseline and post-intervention by a blinded assessor included Visual Analogue Scale (VAS) pain, hand-held dynamometry muscle strength, Statin-Associated Muscle Symptoms Clinical Index (SAMS-CI), and SF-36 Physical and Mental Component Summary scores.
Results: Both groups improved significantly (p < 0.001). Group A showed substantially greater mean changes than Group B in VAS (−3.00 vs −0.90), muscle strength (+5.59 kg vs +1.74 kg), SAMS-CI (−3.77 vs −1.53), SF-36 PCS (+8.70 vs +3.40) and SF-36 MCS (+5.93 vs +1.70), with large between-group effect sizes (Cohen’s d = 2.45–4.03; all p < 0.001). No intervention-related adverse events occurred.
Conclusion: An eight-week supervised moderate-intensity combined aerobic and resistance exercise programme is significantly more effective than conventional physiotherapy in reducing pain and SAMS severity, improving muscle strength and enhancing quality of life in patients with SAMS.