Safety of a home exercise programme in patients with polymyositis and dermatomyositis: a pilot study

Abstract

Our results indicate that this home exercise programme can be safely employed in patients with stable, inactive PM and DM, with beneficial effects on muscle function.

Exercise: An important component of treatment in the idiopathic inflammatory myopathies

“…In the exercise study of patients with inclusion body myositis where the clinical effects were limited, there was no change in muscle size as estimated by repeated MRI investigations [52]. In our own study of patients with chronic polymyositis and dermatomyositis [39], we determined an increased percentage of the slow twitch, oxygen dependent type I fibers in muscle biopsies after 12 weeks of home exercise together with a significant increase of mean fiber area and improved muscle endurance [54]. Further investigations are needed to explore other mechanisms for exercise improvements, such as whether exercise might contribute to reduced hypoxia or to increase capillary density and fiber type composition and fiber area.…”

“…However, both studies reported unchanged s-CK levels after completed exercise periods. As there is a discrepancy between CK-levels and degree of inflammatory infiltrates and muscle impairment [30,41] Alexanderson et al [39] used a more careful approach to evaluate muscle inflammation. The researchers combined analysis from muscle biopsies taken from the vastus lateralis, MRI scans of the thighs, and s-CK levels to evaluate muscle inflammation after a 12-week home exercise program.…”

“…There were no signs of increased muscle inflammation according to analysis of muscle biopsies, MRI, or s-CK levels. The group improved significantly by a median of 15% to 17% reduced impairment, assessed by the FI, and median 23% reduced activity limitation/participation restriction (SF-36; Table 2) [39]. This home exercise program was also evaluated in 11 patients with recent onset active polymyositis and dermatomyositis [40•].…”

Dermatomyositis: current and future treatments

“…It is known that even in patients responding to pharmacologic interventions for muscle disease, a majority develop sustained disability [146]. Studies demonstrate that patients with inflammatory myopathy who participate in exercise and rehabilitation programs tolerate intensive resistance training, report reduced disease activity and have improved muscle strength and endurance [146][147][148][149][150][151][152][153]. Importantly, benefits have been demonstrated even in the course of active disease and have not been shown to induce disease flares [151].…”

Pathophysiological Factors which Determine the Exercise Intolerance in Patients with Juvenile Dermatomyositis

“…Promising results have been found in physical training studies in adult dermatomyositis and polymyositis patients. Clinical trials from different laboratories have evaluated the effects of resistance training disease [50,51] and endurance training [52,53] in an adult dermato/polymyositis patients both with an active disease and in a clinically stable inactive condition. Arnadottir et al, [54,55] found in a pilot study that a 12-week period of home training was safe for patients with inclusion body myositis (another form of inflammatory myositis).…”