The effect of physical exercise following acute disease exacerbation in patients with dermato/polymyositis

Abstract

Objective: To study the effect of physical exercise shortly after an acute episode of dermato/polymyositis (DM/PM). Design: Pilot study of a descriptive nature. Setting: Rehabilitation unit of a large general hospital. Subjects: Ten patients 2–3 weeks after an acute phase of DM/PM (early recovery group) and 11 patients in the inactive stage of DM/PM for at least three months (chronic stage group). Interventions: Isotonic muscle training consisted of several series of different repeated movements at 65–70% of individual maximal repetition limit. Special training was applied for the respiratory muscles. Relaxing baths, mud packs and massages were also applied. Outcome measures: Dynamometer and spirometer were used for measuring the changes in muscle strength and respiratory function. Disability tests were done before and after therapy. Results: No disease relapses or decreases in muscle function were seen. In the early recovery group, the average muscle strength improvement was 17 ± 31% ( p > 0.05) in the proximal muscles and 37 ± 23% ( p < 0.05) in the distal muscles, while the vital capacity also increased by 17 ± 21% ( p < 0.05). In the chronic stage group the average improvement in muscle strength was 46 ± 34% ( p < 0.05) in the proximal muscles and 37 ± 29% ( p < 0.05) in the distal muscles. By the end of the therapy both groups showed improvements in disability tests ( p < 0.05). Conclusions: Physical training started 2–3 weeks following an acute exacerbation of the disease seems to be useful and safe. Some improvement in muscle strength and respiratory function can be obtained, muscle atrophy due to inactivity may be partially prevented and the level of disability can be decreased.