The Role of Exercise to Improve Physiological, Physical and Psychological Health Outcome in Idiopathic Inflammatory Myopathies (IIM)

Lodin, Karin; Espinosa-Ortega, Fabricio; Lundberg, Ingrid; Alexanderson, Helene

doi:10.2147/jir.s377102

Cited by 2 publications

References 117 publications

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High-Intensity Interval Training Outperforms Moderate Exercise to Improve Aerobic Capacity in Patients with Recent-Onset Idiopathic Inflammatory Myopathies: A Multicenter Randomized Controlled Trial

Andreasson,

Leijding,

Dastmalchi

et al. 2024

Preprint

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Objective: To investigate efficacy, safety, and tolerance of high-intensity interval training (HIIT) versus standard low-moderate intensity home-based exercise (CON) to improve aerobic capacity, muscle endurance, and mitochondrial function in patients with recent onset, idiopathic inflammatory myopathies (IIM). Methods: Twenty-three patients with recent onset IIM were randomized into two groups: HIIT and CON. HIIT underwent 12 weeks of supervised high-intensity training, while CON followed a low-moderate intensity home-based exercise program. Outcomes included maximal exercise test (VO2peak, peak power, time-to-exhaustion TTE), mitochondrial protein expression in muscle biopsy serum levels of muscle enzymes (CK, LD, AST, ALT), muscle strength (MMT8) and disease activity (subset of MDAAT), before and after intervention. Results: HIIT resulted in a 16% increase in VO2peak L/min, significantly higher than the 1.8% change in CON (95% CI 0.1;0.47). Peak power and TTE also improved significantly more in HIIT, 18% and 23%, respectively, compared to CON, 8% and 12%, (95% CI 3.9;30.8 and 00:06;03:18, respectively). Muscle biopsies (HIIT n=7, CON n=6) showed increases (p<0.05) in central mitochondrial protein expression in HIIT but not in CON, suggesting enhanced mitochondrial function. Both groups maintained stable serum muscle enzymes indicating no increase in disease activity from the intervention. Muscle disease activity remained low and unchanged in both groups (95% CI -1.2;1.0), physician global activity and MMT8significantly improved within CON (95% CI -1.7;-0.26 and 0.1;3.9, respectively) but not in the HIIT group. Compliance with HIIT was high, and no adverse events were reported. Conclusion: HIIT is a highly effective and safe exercise intervention to improve aerobic fitness, muscle endurance, and mitochondrial function in patients with recent onset IIM. This approach should be considered as an adjuvant treatment in managing IIM, potentially enhancing the health for these patients.

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High-Intensity Interval Training Outperforms Moderate Exercise to Improve Aerobic Capacity in Patients with Recent-Onset Idiopathic Inflammatory Myopathies: A Multicenter Randomized Controlled Trial

Andreasson,

Leijding,

Dastmalchi

et al. 2024

Preprint

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Outpatient Physiotherapy for Immune-Mediated Necrotizing Myositis With a Positive Outcome: Must Pathology Equal Dysfunction? A Case Report

Neufeld,

Johnson,

Wong

2024

JOSPT Cases

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BACKGROUND: Necrotizing Myositis (NM) is a rare autoimmune systemic condition leading to skeletal muscle destruction visualized on Magnetic Resonance Imaging (MRI). The prognosis is severe progressive muscle weakness leading to functional mobility decline. This case study described outpatient physiotherapy management of NM, not hitherto reported, and the unanticipated outcomes given the diagnosis and MRI findings. CASE PRESENTATION: A 77-year-old female was diagnosed with NM, confirmed on MRI significant for abnormal T2 signal in all muscular compartments of both lower extremities, after 4 months of progressive limb weakness had prevented her from walking independently. Outpatient physiotherapy began 10 months after diagnosis. Examination revealed spinal and peripheral joint hypomobility, lower limb weakness (1 repetition, 30s sit to stand-30STS), functional limitation (14/80, Lower Extremity Functional Scale-LEFS), and slow gait with rollator. The physiotherapy diagnosis was that musculoskeletal impairments contributed to movement dysfunction, leading to 18 manual therapy and exercise treatments over 19 weeks. OUTCOMES AND FOLLOW-UP: Strength (8 repetition 30STS) and function (49/80 LEFS) improved beyond minimal clinical important differences and gait speed at discharge approximated age-sex-matched normal. DISCUSSION: For this NM case, strength and function improved despite confirmed muscle necrosis and prognosis of progressive muscle degradation after addressing modifiable musculoskeletal impairments.

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The Role of Exercise to Improve Physiological, Physical and Psychological Health Outcome in Idiopathic Inflammatory Myopathies (IIM)

Cited by 2 publications

References 117 publications

High-Intensity Interval Training Outperforms Moderate Exercise to Improve Aerobic Capacity in Patients with Recent-Onset Idiopathic Inflammatory Myopathies: A Multicenter Randomized Controlled Trial

High-Intensity Interval Training Outperforms Moderate Exercise to Improve Aerobic Capacity in Patients with Recent-Onset Idiopathic Inflammatory Myopathies: A Multicenter Randomized Controlled Trial

Outpatient Physiotherapy for Immune-Mediated Necrotizing Myositis With a Positive Outcome: Must Pathology Equal Dysfunction? A Case Report

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