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A7.22 Effects of whole-body vibration exercise on physical capacity and prostaglandin metabolites in patients with sporadic inclusion body myositis
  1. M Korotkova1,
  2. S Sandström2,
  3. A Hallén2,
  4. H Idborg1,
  5. C Dorph3,
  6. H Alexanderson2
  1. 1Department of Medicine, Rheumatology Unit, Karolinska Institutet, Stockholm, Sweden
  2. 2Department of NVS, Division of Physiotherapy, Karolinska Institutet and Physiotherapy Clinic, Karolinska University Hospital, Solna, Stockholm, Sweden
  3. 3Rheumatology Clinic, Karolinska University Hospital, Stockholm, Sweden

Abstract

Background Sporadic inclusion body myositis (sIBM) is a rare condition with slow progression of muscle weakness and muscle atrophy leading to severe disability. Knowledge of exercise effects in sIBM is limited.

Objective To evaluate the effects of whole-body vibration (WBV) exercise on physical capacity, disease activity and urine levels of prostaglandin metabolites (PG-M) in patients with sIBM.

Methods A single subject experimental design was used including four males with sIBM (aged 67–73, diagnosis duration 3–7 years). All were ambulant. During a 6-week non-interventional A-phase participants (P) were assessed every other week; muscle strength (hand-held myometer), physical capacity (30-metre walking test, Sit-to-stand test, heel-lift test), disease activity (6-item core set; physician/patient global, Manual Muscle test, Health Assessment Questionnaire, CK-levels, extra-muscular scores) and urine PG-M levels as an index of systemic PG production. Urine PG-M levels were analysed using LC-MS/MS. During the 12 week interventional B-phase P exercised four muscle groups in upper/lower extremities twice a week. Assessments continued every other week. Intensity started on 30 Hertz (Hz) in two 30-sec sets, increasing up to 45 Hz, 300-sec sets, 4 sets per muscle group. Two consecutive B-phase assessments above/below the A-phase mean + 2SD represented a statistically significant change. Reduced disease activity was defined according to international consensus; >20% improvement in 3/6 items with worsening >25% in no more than 2 items.

Results P1 experienced the exercise as uncomfortable and stopped after eight weeks and remained unchanged. P2 improved significantly in heel-lift repetitions (A-phase mean 60.3+2SD 27, 4 consecutive B-phase assessments between 100–109), in 30-metre walk time (16.2 + 1.5, 5 between 14.3 – 13.7 s) and had reduced disease activity. P3 improved in sit-to-stand repetitions (10 + 1.5, 3 between 13 – 16). P4 improved in sit-to-stand repetitions (10 + 1.5, 5 between 14 – 18) and in knee extensor strength (36.7 + 3.5, 2 between 48–52 Newton). No changes in systemic production of PGE2 and PGD2 or CK-levels were observed in response to exercise.

Conclusions The WBV exercise resulted in improved physical capacity. This program was safe with stable prostaglandin and CK levels throughout the study. One P even had reduced disease activity.

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