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Muscle Strength and Exercise in Patients with Inflammatory Myopathies

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The Inflammatory Myopathies

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Abstract

Muscle weakness and low muscle endurance are the primary clinical features of the inflammatory myopathies, myositis. Most patients with polymyositis and dermatomyositis respond to medical treatment, but few recover former muscle function. Patients with inclusion body myositis respond poorly to immunosuppressive treatment, and most patients develop progressive muscle weakness. Different mechanisms that cause impaired muscle performance are involved in different subsets of myositis and in different phases of disease. Muscle fiber degeneration and muscle atrophy, as well as an acquired metabolic myopathy, are likely to contribute. In this context, physical exercise is of importance; however, historically patients with myositis have been discouraged from exercising due to the notion that it might be harmful and cause increased muscle inflammation, but importantly, there are no studies or reports supporting this notion. On the contrary, since 1993, a number of studies have reported both efficacy and safety of different kinds of exercise regimens in patients with chronic as well as recent-onset adult polymyositis and dermatomyositis. In addition, exercise may even reduce muscle inflammation. For inclusion body myositis, exercise data are scarce and the effects less convincing on muscle performance. Children with juvenile dermatomyositis, with chronic as well as active disease, tolerate maximal oxygen uptake tests and exercise tolerance tests, supporting the use of exercise also in children with inflammatory myopathies, although there are no studies evaluating effects of exercise employed over weeks or months in children. Overall, physical exercise is beneficial, and there is a clear role for adapted physical exercise as additional therapy in the rehabilitation of patients with inflammatory myopathies.

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  1. Department of Physical Therapy, Orthopedic and Rheumatology Unit, Karolinska University Hospital, Rheumatology Unit, Department of Medicine, Stockholm, Sweden

    Helene Alexanderson & Ingrid E. Lundberg

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  2. Ingrid E. Lundberg
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    © 2009 Humana Press, a part of Springer Science+Business Media, LLC

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    Alexanderson, H., Lundberg, I.E. (2009). Muscle Strength and Exercise in Patients with Inflammatory Myopathies. In: Kagen, L. (eds) The Inflammatory Myopathies. Humana Press. https://doi.org/10.1007/978-1-60327-827-0_16

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    • DOI: https://doi.org/10.1007/978-1-60327-827-0_16

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