Alexanderson Helene, Dastmalchi Maryam, Esbjörnsson-Liljedahl Mona, Opava Christina H, Lundberg Ingrid E
Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
Arthritis Rheum. 2007 Jun 15;57(5):768-77. doi: 10.1002/art.22780.
To investigate the benefits and safety of an intensive muscular training program in patients with chronic polymyositis (PM) and dermatomyositis (DM).
Nine patients with chronic PM or DM (median age 53 years, range 44-61) were included. Assessments of impairment (10-15 voluntary repetition maximum [VRM], the Functional Index 2 [FI-2], the Grippit, and pain rated on the Borg CR-10 scale), activity limitation (Myositis Activities Profile), and participation restriction (patients' disease impact on well-being) were performed 4 weeks prior to baseline, at baseline, and after 7 weeks of exercise. A 6-item core set of disease activity measures was administered and muscle biopsy samples of vastus lateralis were obtained at baseline and after 7 weeks of exercise. Response criteria at an individual level were set for disability and disease activity. The patients exercised 3 days per week for 7 weeks on loads allowing 10 VRM.
On a group level there were no significant differences between assessments at 4 weeks before baseline compared with baseline. The group improved significantly regarding 10-15 VRM and FI-2 at 7 weeks compared with baseline (P < 0.05). All patients were responders with respect to impairment and 2 were activity limitation responders whereas participation restriction remained unchanged in all. Two patients were responders with reduced disease activity and no patient had signs of increased muscle inflammation in the muscle biopsy sample after 7 weeks of exercise.
Patients with chronic, stable PM and DM can perform this intensive resistive exercise program with beneficial effects on impairment and activity limitation without increased muscle inflammation.
探讨强化肌肉训练计划对慢性多发性肌炎（PM）和皮肌炎（DM）患者的益处及安全性。
纳入9例慢性PM或DM患者（中位年龄53岁，范围44 - 61岁）。在基线前4周、基线时以及运动7周后，进行功能障碍评估（10 - 15次最大自主重复次数[VRM]、功能指数2[FI - 2]、握力以及用Borg CR - 10量表评定的疼痛）、活动受限评估（肌炎活动量表）和参与限制评估（患者疾病对幸福感的影响）。在基线时和运动7周后，实施一套6项的疾病活动核心指标评估，并获取股外侧肌的肌肉活检样本。为残疾和疾病活动设定了个体水平的反应标准。患者每周锻炼3天，共7周，负荷为能完成10次VRM。
在组水平上，基线前4周与基线时的评估之间无显著差异。与基线相比，该组在7周时10 - 15次VRM和FI - 2方面有显著改善（P < 0.05）。所有患者在功能障碍方面均有反应，2例患者在活动受限方面有反应，而所有患者的参与限制均未改变。2例患者疾病活动有改善，运动7周后肌肉活检样本中无患者出现肌肉炎症加重的迹象。
慢性、稳定的PM和DM患者可以进行这种强化抗阻运动计划，对功能障碍和活动受限有有益影响，且不会增加肌肉炎症。
