Bertolucci F, Neri R, Dalise S, Venturi M, Rossi B, Chisari C
Unit of Neurorehabilitation, University Hospital of Pisa, Italy -
Eur J Phys Rehabil Med. 2014 Apr;50(2):161-9. Epub 2013 Jul 2.
Polymyositis (PM) and Dermatomyositis (DM) are chronic, inflammatory and autoimmune skeletal muscle disorders characterized by reduced muscle strength, fatigue and myalgia. While inflammation causes muscle damage in the early phase, metabolic alterations such as an impairment of oxidative metabolism seem to be responsible for the disability in the chronic phase of the disease.
To assess muscle oxidative efficiency and to test the effect of aerobic training in a group of PM/DM patients.
A case-control study and a within-group comparison. SETTING. Outpatients of the Unit of Neurorehabilitation of the University Hospital of Pisa.
20 patients with myositis (15 PM and 5 DM) and 15 healthy subjects as a control group.
The test consisted of an incremental, sub-maximal aerobic exercise on a treadmill; haematic lactate was assessed at rest and after 1', 5', 10' and 30' minutes from the end of the exercise. A within-group comparison was conducted on four of the PM patients (P group). They were subjected to six weeks aerobic training. Lactate curve and functional tests were assessed before and after the treatment.
A precocious fatigability and significantly higher values of lactate at rest and after the exercise were observed in patients. In the P group mean lactate levels were significantly decreased after the treatment and an improvement of muscle performance was observed.
Abnormal blood lactate levels suggested an impaired muscle oxidative efficiency in PM/DM patients. A specific aerobic training program reduced lactate levels and relieved fatigue symptoms in a within-group of four of the PM patients.
Such a specific aerobic training program could be introduced in everyday practice for the rehabilitative treatment of PM/DM patients.
多发性肌炎（PM）和皮肌炎（DM）是慢性、炎症性自身免疫性骨骼肌疾病，其特征为肌肉力量减弱、疲劳和肌痛。虽然炎症在疾病早期会导致肌肉损伤，但代谢改变，如氧化代谢受损，似乎是疾病慢性期残疾的原因。
评估一组PM/DM患者的肌肉氧化效率，并测试有氧训练的效果。
病例对照研究和组内比较。地点：比萨大学医院神经康复科门诊。
20例肌炎患者（15例PM和5例DM）和15名健康受试者作为对照组。
测试包括在跑步机上进行递增的次最大有氧运动；在运动结束后休息时以及1分钟、5分钟、10分钟和30分钟后评估血乳酸水平。对4例PM患者（P组）进行组内比较。他们接受了为期六周的有氧训练。在治疗前后评估乳酸曲线和功能测试。
患者表现出过早疲劳，且休息时和运动后的乳酸值显著更高。在P组中，治疗后平均乳酸水平显著降低，肌肉性能有所改善。
血乳酸水平异常表明PM/DM患者的肌肉氧化效率受损。一项特定的有氧训练计划降低了乳酸水平，并缓解了P组中4例PM患者的疲劳症状。
这种特定的有氧训练计划可引入日常实践中，用于PM/DM患者的康复治疗。
