Crisafulli Oscar, Lacetera Jessica, Bottoni Giorgio, Berardinelli Angela, Grattarola Luca, Veltroni Martina, Acquadro Stefano, Negro Massimo, Lavaselli Emanuela, D'Antona Giuseppe
Criams-Sport Medicine Centre Voghera, University of Pavia, Voghera, Italy.
Child Neuropsychiatry, IRCCS Mondino Foundation, Pavia, Italy.
Front Physiol. 2024 Jul 23;15:1404657. doi: 10.3389/fphys.2024.1404657. eCollection 2024.
Patients with central core myopathy (CCM) can be at risk of exercise-induced rhabdomyolysis and myalgia. Despite its possible positive effects, physical training has been long avoided in these patients as no population-specific exercise adaption strategies have been developed. Here we present the case of a 17-year-old male CCM patient who underwent a 3-month training program tailored to a preliminary test aimed at assessing his physical exertion tolerance measured via changes in serum creatine kinase (CK).
The preliminary tolerance test consisted of three 25-minute sessions (one session per week) of physical exercise (aerobic, resistance and mixed) at an intensity quantified as level 6 of the Borg Category Ratio (CR) 0-10 scale. A blood sample to assess CK was conducted 36 h following eachsession. The intervention consisted of a training program (three sessions per week) including both resistance and aerobic exercises concomitant with a personalized nutritional plan. Before and after intervention, a battery of metabolic (indirect calorimetry, bioimpedance) and cardiopulmonary (CPET) tests were performed.
After training, improvements of the anaerobic threshold (+6.9%), normalized VO max (+15%) and body composition (muscle mass, +1.1 kg; fat mass, -1.1 kg were observed without pain, rhabdomyolysis, and blood CK augmentation compared to pretraining values.
Our results highlight that a mixed aerobic/resistance training, properly tailored and supported by a specific nutritional plan, may safely improve the physical fitness and body composition in a CCM patient. Dosing exercise-induced CK serum change following Borg CR-10 intensity assessment, may be useful to correctly tailor physical exercise in these patients.
中央轴空病（CCM）患者有运动诱发横纹肌溶解症和肌痛的风险。尽管体育锻炼可能有积极作用，但由于尚未制定针对该人群的运动适应策略，这些患者长期以来一直避免进行体育锻炼。在此，我们报告一例17岁男性CCM患者的病例，该患者接受了为期3个月的训练计划，该计划是根据一项初步测试量身定制的，该测试旨在通过血清肌酸激酶（CK）的变化来评估其体力耐受能力。
初步耐受测试包括每周一次、每次25分钟的三次体育锻炼（有氧运动、抗阻运动和混合运动），强度按照Borg类别比率（CR）0 - 10级量表的6级进行量化。每次锻炼后36小时采集血样以评估CK。干预措施包括一个训练计划（每周三次），包括抗阻运动和有氧运动，同时还有个性化的营养计划。在干预前后，进行了一系列代谢（间接测热法、生物电阻抗法）和心肺（心肺运动试验）测试。
训练后，观察到无氧阈值提高（+6.9%）、VO₂max正常化（+15%）以及身体成分改善（肌肉量增加1.1千克；脂肪量减少1.1千克），与训练前相比，没有疼痛、横纹肌溶解症和血CK升高的情况。
我们的结果表明，经过适当调整并辅以特定营养计划的有氧/抗阻混合训练，可以安全地改善CCM患者的身体素质和身体成分。根据Borg CR - 10强度评估来确定运动诱发的CK血清变化量，可能有助于为这些患者正确调整体育锻炼方案。
