The physiological and physical determinants of functional ability measures in children with juvenile dermatomyositis

Takken, Tim; Elst, E; Spermon, Naomi; Helders, Paul J. M.; Prakken, A. B. J.; Net, Janjaap van der

doi:10.1093/rheumatology/keg210

Cited by 59 publications

(36 citation statements)

References 15 publications

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“…In a previous cross‐sectional study, we found that the CMAS was strongly associated with V O 2peak (44); the current observation that changes in CMAS score are associated with improvements in exercise parameters strengthens this previous finding. The CMAS might therefore be considered a measure of muscle endurance.…”

Section: Discussionsupporting

confidence: 82%

Responsiveness of exercise parameters in children with inflammatory myositis

Takken¹,

Net²,

Engelbert³

et al. 2007

Arthritis & Rheumatism

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Objective. Juvenile dermatomyositis (DM) is an inflammatory myopathy in which the immune system targets the microvasculature of the skeletal muscle and skin, leading to significant muscle weakness and exercise intolerance, although the precise etiology is unknown. The goal of this study was to investigate the changes in exercise capacity in children with myositis during active and inactive disease periods and to study the responsiveness of exercise parameters. Methods. Thirteen children with juvenile DM (mean ؎ SD age 11.2 ؎ 2.6 years) participated in this study. Patients performed a maximal exercise test using an electronically braked cycle ergometer and respiratory gas analysis system. Exercise parameters were analyzed, including peak oxygen uptake (VO 2peak ), peak work rate (W peak ), and ventilatory anaerobic threshold (VAT). All children were tested during an active period of the disease and during a remission period. From these data, 4 different response statistics were calculated. Results. The children performed significantly better during a remission period compared with a period of active disease. Most exercise parameters showed a very large response. The 5 most responsive parameters were W peak , W peak (percent predicted), oxygen pulse, VO 2peak , and power at the VAT. Conclusion. We found in our longitudinal study that children with active juvenile DM had significantly reduced exercise parameters compared with a remission period. Moreover, we found that several parameters had very good responsiveness. With previously established validity and reliability, exercise testing has been demonstrated to be an excellent noninvasive instrument for the longitudinal followup of children with myositis.

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Section: Discussionsupporting

confidence: 82%

Responsiveness of exercise parameters in children with inflammatory myositis

Takken¹,

Net²,

Engelbert³

et al. 2007

Arthritis & Rheumatism

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“…10 It is well known that muscle enzymes can be normal even in active disease with myositis and, thus, there are no perfect parameters for documenting muscle inflammation. 11 Given sampling errors and low specificity of muscle biopsy and EMG, some practitioners defer more invasive diagnostic testing and imaging if no muscle symptoms are present, and proceed with sequential objective physical examinations, documenting muscle strength and function, because skin findings may precede muscle disease or be the only manifestations of DM. 12 The overwhelming majority of patients in our data set had adult-onset disease (Tables I and III).…”

Section: Discussionmentioning

confidence: 99%

Number, characteristics, and classification of patients with dermatomyositis seen by dermatology and rheumatology departments at a large tertiary medical center

Klein

Teal

Taylor

et al. 2007

Journal of the American Academy of Dermatology

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“…Since the introduction of new therapies, the attention of outcome measures has shifted from mortality toward morbidity, functional ability, and exercise capacity (18). The aim of this study was to describe the feasibility of the WAnT in patients with JIIM, to compare their anaerobic exercise capacity with that of healthy controls, and to relate the anaerobic exercise capacity to disease duration or activity.…”

Section: Discussionmentioning

confidence: 99%

Anaerobic exercise capacity in patients with juvenile‐onset idiopathic inflammatory myopathies

Takken¹,

Net²,

Helders³

2005

Arthritis & Rheumatism

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Objective. To 1) report the feasibility of an "all-out" 30-second cycling exercise test (Wingate Anaerobic Exercise Test [WAnT]) in juvenile-onset idiopathic inflammatory myopathy (JIIM) patients, 2) describe the anaerobic exercise capacity in juvenile dermatomyositis patients, and 3) determine if the anaerobic exercise capacity could be related to disease duration or disease phase. Methods. Twenty patients (age 14.13 ؎ 5.4 years) with JIIM participated in this study. All patients were able to perform the WAnT without adverse events. Results. Comparison with healthy controls revealed a -29.3 ؎ 26.58% (P ‫؍‬ 0.001) and -27.6 ؎ 25.7% (P ‫؍‬ 0.002) impairment in mean power and peak power on the WAnT, respectively. The WAnT correlated with disease phase and with knee extensor muscle strength. Conclusion. The WAnT might be a valuable adjunct next to other assessment tools in the followup of JIIM patients.

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The physiological and physical determinants of functional ability measures in children with juvenile dermatomyositis

Abstract: CMAS, CHAQ and CHQ correlate with muscle strength and VO(2peak). CMAS, CHAQ and CHQ depend on different physical and physiological variables.

Cited by 59 publications

References 15 publications

Responsiveness of exercise parameters in children with inflammatory myositis

Responsiveness of exercise parameters in children with inflammatory myositis

Number, characteristics, and classification of patients with dermatomyositis seen by dermatology and rheumatology departments at a large tertiary medical center

Anaerobic exercise capacity in patients with juvenile‐onset idiopathic inflammatory myopathies

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