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AB1193 Important role of the exercise training in juvenile dermatomyositis
  1. C.H. Omori1,
  2. C.A.A. Silva1,
  3. A.M.E. Sallum1,
  4. R.M. Pereira2,
  5. A.L.S. Pinto2,
  6. H. Roschel3,
  7. B. Gualano3
  1. 1Pediatric Rheumatology
  2. 2Rheumatology, Faculdade de Medicina da USP
  3. 3Physical Education and Sports, USP, Sao Paulo, Brazil

Abstract

Background Juvenile dermatomyositis (JDM) belongs to a heterogeneous group of diseases known as idiopathic inflammatory myopathies that share common symptoms, such as a proximal muscle weakness and a nonsuppurative inflammation of the skeletal muscle. The prognosis of JDM in terms of physical function is often positive. However, many patients continue to present chronic illness and suffer sequelae of the disease. In this regard, it has been speculated that exercise training could promote functional benefits to these patients, ultimately leading to improvements in their quality of life.

Objectives To investigate the effects a supervised exercise training program on health-related quality of life, health parameters, physical capacity, bone mass and body composition in a cohort of juvenile dermatomyositis patients.

Methods This was a prospective longitudinal study. The sample consisted of 10 children with JDM. The exercise program consisted of a twice-a-week supervised aerobic and resistance training. At baseline and after the 12-week intervention, we assessed health-related quality of life, JDM scores (DAS, CMAS, MMT) aerobic conditioning, muscle strength and function, bone mineral apparent density and body composition.

Results Both the child self-report and the parent proxy-report PedsQL scores improved after the intervention (-40.3%, p=0.001 and -48.2%, p=0.049 respectively). Importantly, DAS score reduced after the exercise (-26.9%, p=0.026), CMAS score improved after exercise (+2.5%, p=0.009) and MMT presented a trend towards statistical significance (+2.2%, p=0.081). The V02peak and time-to-exhaustion increased by 13.3% (p=0.001) and 18.2% (p=0.003), respectively, whereas resting heart-rate decreased by 14.7% (p=0.006), indicating important cardiovascular adaptations to the exercise program. Upper- and lower-limb muscle strength and muscle function also improved significantly after the exercise training (p<0.05). Both the whole body and the lumbar spine bone mineral apparent density increased significantly after training (1.44%, p=0.044 and 2.85%, p=0.008, respectively).

Conclusions We showed for the first time that a 12-week supervised exercise program is safe and can improve health-related quality of life, disease activity, aerobic conditioning, muscle strength and function, and bone mass in patients with active and non-active chronic JDM.

  1. de Salles Painelli V, Gualano B, Artioli GG, de Sa Pinto AL, Bonfa E, Lancha Junior AH, et al. The possible role of physical exercise on the treatment of idiopathic inflammatory myopathies. Autoimmun Rev 2009;8:355-9.

  2. Feldman BM, Rider LG, Reed AM, Pachman LM. Juvenile dermatomyositis and other idiopathic inflammatory myopathies of childhood. Lancet 2008;371:2201-12.

  3. Harris-Love MO. Physical activity and disablement in the idiopathic inflammatory myopathies. Curr Opin Rheumatol 2003;15:679-90

Disclosure of Interest None Declared

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