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Physical activity in idiopathic inflammatory myopathies: two intervention proposals based on literature review

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Abstract

Idiopathic inflammatory myopathies (IIM) are rare diseases affecting skeletal muscles and leading to progressive muscle weakness and disability. Thanks to the better understanding of their pathogenesis, the management of IIM has been noteworthily implemented in recent years. Current therapeutic strategies include pharmacological and non-pharmacological interventions, among which physical exercise represents a useful option, able to ameliorate disease activity without worsening muscle inflammation. The aim of this narrative review is therefore to provide an updated overview of the benefits of physical exercise in patients with IIM and to suggest plausible training programs to be applied in patients with dermatomyositis, polymyositis, necrotizing myopathy, and inclusion body myositis. In this regard, a combined strategy mixing aerobic and resistance exercises could positively affect the pro-inflammatory and metabolic pathways occurring in skeletal muscles, while promoting muscle fiber regeneration and repair.

Key Points

•In IIM patients physical activity improves residual muscle function and prevents muscle atrophy

• The constant practice of physical activity may also lead to cardiopulmonary, endocrine and immunological benefits in IIM patients

• We formulate evidence-based protocols combining aerobic and resistance exercises to be recommended in dermatomyositis, polymyositis, necrotizing myopathy and inclusion body myositis patients

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Authors and Affiliations

  1. Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Messina, AOU “G. Martino”, via Consolare Valeria 1, 98124, Messina, Italy

    Rossella Talotta

  2. Degree Course of Theory and Methods of Preventive and Adapted Physical Activities, BIOMORF Department, University of Messina, AOU “G. Martino”, via Consolare Valeria 1, 98124, Messina, Italy

    Irene Porrello & Ludovico Magaudda

  3. Postgraduate School of Sport and Physical Exercise Medicine, BIOMORF Department, University of Messina, AOU “G. Martino”, via Consolare Valeria 1, 98124, Messina, Italy

    Roberto Restuccia & Ludovico Magaudda

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  1. Rossella Talotta
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  2. Irene Porrello
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  4. Ludovico Magaudda
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Contributions

RT conceived the idea and wrote the final version of the manuscript, helped perform bibliographic research, drew the figure, edited tables, and critically revised the paper. IP performed bibliographic research, wrote the first draft of the manuscript and tables, and designed physical protocols. RR revised the manuscript and physical protocols. LM critically revised the manuscript. All the authors have approved the final version of the manuscript and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Rossella Talotta.

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Talotta, R., Porrello, I., Restuccia, R. et al. Physical activity in idiopathic inflammatory myopathies: two intervention proposals based on literature review. Clin Rheumatol 41, 593–615 (2022). https://doi.org/10.1007/s10067-021-05954-7

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