Abstract

Physical exercise is recommended to be combined with pharmacological treatment for patients with myositis. Physical exercise is capable of inducing both beneficial systemic and local skeletal muscle adaptations and has an indirect potential to improve comorbidities such as cardiovascular risk factors and the metabolic syndrome. During this session, current evidence on disease modifying effects of physical exercise in patients with myositis will be presented. Also, specific molecular mechanisms underlying beneficial adaptations in skeletal muscle to physical exercise in these patients will be discussed.

Take home messages:

Physical exercise added to pharmacological treatment has a potential to reduce clinical disease activity in established myositis, as well as improve muscle performance potentially by improved aerobic capacity.

Exercise improves the aerobic milieu in skeletal muscle in patients with myositis.

Gene expression and proteomic analysis of exercised skeletal muscle from patients with myositis identified specific molecular adaptations such as activation of the aerobic phenotype including mitochondrial oxidative phosphorylation, mitochondrial biogenesis and capillary growth. Also, activation of the muscle growth program and suppression of the inflammatory response in muscles were identified.

Recent findings, after 12 weeks of endurance exercise in patients with myositis, support increased fat metabolism during exercise in skeletal muscle, concurrent with reduced systemic insulin resistance. These metabolic observations may be important as an indirect anti-inflammatory effect of physical exercise in myositis.

Supported exercise in recent-onset myositis is safe and does not aggravate inflammatory pathways. In contrary, early introduced exercise may have long term beneficial effects.