Moyon Q, Benveniste O
DHUI2B, UMR974, UPMC, département de médecine interne et immunologie clinique, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
DHUI2B, UMR974, UPMC, département de médecine interne et immunologie clinique, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
Rev Med Interne. 2016 Nov;37(11):751-758. doi: 10.1016/j.revmed.2016.08.004. Epub 2016 Sep 9.
Rehabilitation, for a long time not recommended, seems today to hold a prominent place within the therapeutic arsenal of inflammatory myopathies. The difficulty of its evaluation, apart from the low prevalence of these diseases, lies in a triple heterogeneity: first that distinguishing the different forms of inflammatory myopathies and the phase where they are active; second, that concerning the endpoint considered to assess the efficiency of the intervention; lastly, the diversity of the rehabilitation programs that can be undertaken. Between 1993 and 2016, about 30 studies estimating the rehabilitation of inflammatory myopathies have been published, among which five randomized controlled trials, four controlled trials, 15 open studies, and seven case reports. All these studies evidence the safety of rehabilitation and some show a significant improvement of the criteria estimating the activity of the disease, its functional impact or the impairment of quality of life and the limitation in daily life activities triggered by the disease. The rehabilitation, whether aerobic, anaerobic or mixed, must today systematically be associated with the pharmaceutic treatment proposed to patients affected by inflammatory myopathies. Other studies are necessary to optimize the rehabilitation methods, to understand their effects and action, and to quantify their impact and provide more trustworthy evidence.
长期以来不被推荐的康复治疗,如今在炎性肌病的治疗手段中似乎占据了显著地位。除了这些疾病的低患病率外,其评估的困难还在于三重异质性:首先是区分炎性肌病的不同形式及其活跃阶段;其次是关于用于评估干预效果的终点;最后是可采用的康复计划的多样性。1993年至2016年间,已发表了约30项评估炎性肌病康复治疗的研究,其中有5项随机对照试验、4项对照试验、15项开放性研究和7例病例报告。所有这些研究都证明了康复治疗的安全性,一些研究表明在评估疾病活动度、其功能影响或生活质量损害以及该疾病引发的日常生活活动受限等标准方面有显著改善。如今,无论是有氧、无氧还是混合性的康复治疗,都必须系统地与针对炎性肌病患者的药物治疗相结合。还需要开展其他研究来优化康复方法,了解其效果和作用机制,并量化其影响,以提供更可靠的证据。