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P099 Intensive 24-week physiotherapy programme in patients with idiopathic inflammatory myopathies – preliminary data from a single-centre controlled study
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  1. M Spiritovic1,2,
  2. S Oreska1,3,
  3. H Storkanova1,3,
  4. P Cesak2,
  5. A Rathouska1,
  6. K Kubinova1,
  7. M Klein1,
  8. L Vernerova1,
  9. O Ruzickova1,3,
  10. H Mann1,3,
  11. K Pavelka1,3,
  12. L Senolt1,3,
  13. J Vencovský1,3,
  14. M Tomcik1,3
  1. 1Institute of Rheumatology, Prague, Czech Republic
  2. 2Faculty of Physical Education and Sport, Charles University, Prague
  3. 3Department of Rheumatology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic, Czech Republic

Abstract

Introduction Presence of muscular inflammation, followed by atrophy in idiopathic inflammatory myopathies (IIM) leads to impaired function, reduced muscle strength, endurance and aerobic capacity, decreasing quality of life. Data on the efficacy of non-pharmacologic care in IIM is very limited due to variety in studied interventions/outcomes.

Objectives To address the limitations of existing studies, and evaluate the effect of a controlled, long-term (24 week intervention, 24 week follow-up), intensive (1 hour physiotherapy twice weekly, and home-exercise for 1 hour 5x weekly), tailored physiotherapy program to improve muscle strength, endurance and deep stabiliser system, and quality of life/disability in cohorts with a substantial number of IIM patients.

Methods All patients fulfilled the Bohan and Peter 1975 diagnostic criteria, had muscle involvement, and were consecutively recruited between 2014–2016. At months 0,3,6,12 all patients were assessed by a physician (physical examination, MITAX, MYOACT, and MDI), and a physiotherapist blinded to intervention (MMT-8 – muscle strength test, FI-2 – muscle endurance test), patients filled out patient reported outcomes (PRO)/questionnaires (HAQ, SF-36, Beck’s depression inventory-II (BDI-II), PROs assessing nutrition and fatigue), body composition was analysed using densitometry (iDXA Lunar) and bioelectric impedance (BIA2000-M), and patients provided blood for routine laboratory analysis and biobanking. Normality of data was tested and inter-group analysis performed with 2-way ANOVA and intra-group analysis by Friedman’s test with Dunn’s post hoc test.

Results 27 IIM patients were recruited into the intervention group (IG) and 27 patients into the control group (CG). Compared to observed statistically significant deterioration in CG over the period of months 0–6, we found statistically significant improvement in FI-2, MMT8, HAQ, BDI-II. Only numerical improvement in IG compared to numerical deterioration in CG, which has not reached statistical significance, was observed in SF-36 and fatigue PROs.

Conclusions Our physiotherapy program led to a significant improvement in muscle strength, endurance, and function. Additionally, patients expressed a decrease in the level of depression. The improvements were clinically meaningful in a substantial proportion of patients.

Acknowledgements Supported by AZV-16–33574A.

Disclosure of interest None declared

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