Proposal for a Candidate Core Set of Fitness and Strength Tests for Patients with Childhood or Adult Idiopathic Inflammatory Myopathies

Abstract

OBJECTIVES Currently there are no evidence-based recommendations regarding which fitness and strength tests to use for patients with childhood or adult idiopathic inflammatory myopathies (IIM). This hinders clinicians and researchers in choosing the appropriate fitness- or muscle strength-related outcome measures for these patients. Through a Delphi survey, we aimed to identify a candidate core-set of fitness and strength tests for children and adults with IIM. METHODS Fifteen experts participated in a Delphi survey that consisted of five stages to achieve a consensus. Using an extensive search of published literature and through the expertise of the experts, a candidate core-set based on expert opinion and clinimetric properties was developed. Members of the International Myositis Assessment and Clinical Studies Group (IMACS) were invited to review this candidate core-set during the final stage, which led to a final candidate core-set. RESULTS A core-set of fitness- and strength-related outcome measures was identified for children and adults with IIM. For both children and adults, different tests were identified and selected for maximal aerobic fitness, submaximal aerobic fitness, anaerobic fitness, muscle strength tests and muscle function tests. CONCLUSIONS The core-set of fitness and strength-related outcome measures provided by this expert consensus process will assist practitioners and researchers in deciding which tests to use in IIM patients. This will improve the uniformity of fitness and strength tests across studies, thereby facilitating the comparison of study results and therapeutic exercise program outcomes among patients with IIM.

Physical (in)activity and its influence on disease-related features, physical capacity, and health-related quality of life in a cohort of chronic juvenile dermatomyositis patients

“…Our findings seem to substantiate this recommendation, as some of the muscle strength/function tests applied in this study (i.e., 1-RM bench press, 1-RM leg press, timed-stands test) revealed lower muscle function in JDM patients, all of them with maximal scores in MMT. Therefore, we reinforce the idea that a series of tests, rather than only MMT and/or handgrip, should be applied in either clinical setting or research to sensitively assess muscle function in chronic JDM patients, with the guidance of the recently proposed core set [37]. Previous studies have shown that JDM patients often experience decreased strength and aerobic and anaerobic capacity [4][5][6].…”

“…Another possible insight from the current study is that conventional clinical measures may be not sufficiently sensitive to detect impairments in fitness and functionality in chronic JDM patients with mild disease and no clinical evidence of muscle dysfunction. Recently, a candidate core set of fitness and strength tests for JDM patients was proposed through a Delphi survey [37]. This core set recommends the use of MMT to assess muscle strength; however, in order to improve the knowledge on the patient's strength, additional tests are advised when MMT score of Z6 is achieved in a particular muscle group.…”

239th ENMC International Workshop: Classification of dermatomyositis, Amsterdam, the Netherlands, 14–16 December 2018

“…Recently, there has been a proposal for a candidate coreset of fitness and strength tests for patients with childhood or adult IIMs. It includes treadmill exercise stress test (modified Bruce protocol), incremental cycle ergometer test, 6 min walk test (6MWT), handgrip strength, MMT, CMAS in children, and FI-2 in adults [152] .…”

Musculoskeletal Involvement in Systemic Sclerosis: An Unexplored Aspect of the Disease

“…Based on a Delphi exercise, handgrip strength assessment with dynamometer and manual muscle testing (MMT8) were recently included in the core set of muscle strength tests for patients with idiopathic inflammatory myopathy (130). Performance-based functional capacity testing was also recommended in patients with inflammatory myopathy for a better characterisation of the disease.…”