Skip to main content
SpringerLink
Log in

Role of Exercise in the Management of Myositis

  • Chapter
  • First Online:
Managing Myositis

  • 1064 Accesses

Abstract

Exercise in myositis has been controversial due to fear of increased disease activity. However, during the last several years, evidence has emerged supporting that exercise not only improves physical capacity and self-reported health but also can reduce disease activity and inflammatory markers in serum as well as in muscle tissue in adult polymyositis (PM) and dermatomyositis (DM). All small studies on exercise in inclusion body myositis (IBM) conclude that exercise is safe as to disease activity and inflammation; however, evidence on the response of exercise on muscle strength and physical capacity is somewhat diverging. Exercise is also safe in patients with juvenile dermatomyositis (JDM) with positive effects on functional capacity. Today, exercise including hand exercise, adapted to disease activity and patient’s fatigue and pain, is an important part of treatment in all patients with myositis. Exercise is one of the few treatment modalities that could improve physical capacity in individuals with IBM. Exercise adapted to the disease and performed logically is medicine without side effects.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Warhol MJ, Siegel AJ, Evans WJ, Silverman LM. Skeletal muscle injury and repair in marathon runners after competition. Am J Pathol. 1985;118(2):331–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  2. Pokora I, Kempa K, Chrapusta SJ, Langfort J. Effects of downhill and uphill exercises of equivalent submaximal intensities on selected blood cytokine levels and blood creatine kinase activity. Biol Sport. 2014;31(3):173–8.

    Article  CAS  Google Scholar 

  3. Benatti FB, Pedersen BK. Exercise as an anti-inflammatory therapy for rheumatic diseases-myokine regulation. Nat Rev Rheumatol. 2015;11(2):86–97.

    Article  CAS  Google Scholar 

  4. Sloan RP, Shapiro PA, Demeersman RE, McKinley PS, Tracey KJ, Slavov I, et al. Aerobic exercise attenuates inducible TNF production in humans. J Appl Physiol (1985). 2007;103(3):1007–11.

    Article  Google Scholar 

  5. Forti LN, Van Roie E, Njemini R, Coudyzer W, Beyer I, Delecluse C, et al. Effects of resistance training at different loads on inflammatory markers in young adults. Eur J Appl Physiol. 2017;117(3):511–9.

    Article  CAS  Google Scholar 

  6. Alexanderson H, Dastmalchi M, Esbjornsson-Liljedahl M, Opava CH, Lundberg IE. Benefits of intensive resistance training in patients with chronic polymyositis or dermatomyositis. Arthritis Rheum. 2007;57(5):768–77.

    Article  Google Scholar 

  7. Nader GA, Dastmalchi M, Alexanderson H, Grundtman C, Gernapudi R, Esbjornsson M, et al. A longitudinal, integrated, clinical, histological and mRNA profiling study of resistance exercise in myositis. Mol Med. 2010;16(11–12):455–64.

    Article  CAS  Google Scholar 

  8. Alemo Munters L, Dastmalchi M, Andgren V, Emilson C, Bergegard J, Regardt M, et al. Improvement in health and possible reduction in disease activity using endurance exercise in patients with established polymyositis and dermatomyositis: a multicenter randomized controlled trial with a 1-year open extension followup. Arthritis Care Res (Hoboken). 2013;65(12):1959–68.

    Article  Google Scholar 

  9. Munters LA, Loell I, Ossipova E, Raouf J, Dastmalchi M, Lindroos E, et al. Endurance Exercise Improves Molecular Pathways of Aerobic Metabolism in Patients With Myositis. Arthritis Rheumatol. 2016;68(7):1738–50.

    Article  CAS  Google Scholar 

  10. Alemo Munters L, Dastmalchi M, Katz A, Esbjornsson M, Loell I, Hanna B, et al. Improved exercise performance and increased aerobic capacity after endurance training of patients with stable polymyositis and dermatomyositis. Arthritis Res Ther. 2013;15(4):R83.

    Article  Google Scholar 

  11. Alexanderson H, Stenstrom CH, Jenner G, Lundberg I. The safety of a resistive home exercise program in patients with recent onset active polymyositis or dermatomyositis. Scand J Rheumatol. 2000;29(5):295–301.

    Article  CAS  Google Scholar 

  12. Alexanderson H, Munters LA, Dastmalchi M, Loell I, Heimburger M, Opava CH, et al. Resistive home exercise in patients with recent-onset polymyositis and dermatomyositis – a randomized controlled single-blinded study with a 2-year followup. J Rheumatol. 2014;41(6):1124–32.

    Article  Google Scholar 

  13. Mattar MA, Gualano B, Roschel H, Perandini LA, Dassouki T, Lima FR, et al. Exercise as an adjuvant treatment in persistent active polymyositis. J Clin Rheumatol. 2014;20(1):11–5.

    Article  Google Scholar 

  14. Alexanderson H. Physical exercise as a treatment for adult and juvenile myositis. J Intern Med. 2016;280(1):75–96.

    Article  CAS  Google Scholar 

  15. Chung YL, Alexanderson H, Pipitone N, Morrison C, Dastmalchi M, Stahl-Hallengren C, et al. Creatine supplements in patients with idiopathic inflammatory myopathies who are clinically weak after conventional pharmacologic treatment: Six-month, double-blind, randomized, placebo-controlled trial. Arthritis Rheum. 2007;57(4):694–702.

    Article  CAS  Google Scholar 

  16. Spector SA, Lemmer JT, Koffman BM, Fleisher TA, Feuerstein IM, Hurley BF, et al. Safety and efficacy of strength training in patients with sporadic inclusion body myositis. Muscle Nerve. 1997;20(10):1242–8.

    Article  CAS  Google Scholar 

  17. Johnson LG, Edwards DJ, Walters S, Thickbroom GW, Mastaglia FL. The effectiveness of an individualized, home-based functional exercise program for patients with sporadic inclusion body myositis. J Clin Neuromus Dis. 2007;8(4)

    Article  Google Scholar 

  18. Johnson LG, Collier KE, Edwards DJ, Philippe DL, Eastwood PR, Walters SE, et al. Improvement in aerobic capacity after an exercise program in sporadic inclusion body myositis. J Clin Neuromuscul Dis. 2009;10(4):178–84.

    Article  Google Scholar 

  19. Habers EA, Bos GJ, Langbroek-Amersfoort AC, Lelieveld OT, Abrust W, Takken T, et al. Muscles in motion: a randomized controlled trial on the feasability, safety and efficacy of an exercise training program in children and adolescents with juvenile dermatomyositis. Rheumatology (Oxford). 2016;55(7):1251–62.

    Article  Google Scholar 

  20. Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007;39(8):1423–34.

    Article  Google Scholar 

  21. Eurenius E, Brodin N, Lindblad S, Opava CH, Group PS. Predicting physical activity and general health perception among patients with rheumatoid arthritis. J Rheumatol. 2007;34(1):10–5.

    PubMed  Google Scholar 

  22. Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14(5):377–81.

    Article  CAS  Google Scholar 

  23. Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011;43(7):1334–59.

    Article  Google Scholar 

  24. Harris-Love MO, Shrader JA, Koziol D, Pahlajani N, Jain M, Smith M, et al. Distribution and severity of weakness among patients with polymyositis, dermatomyositis and juvenile dermatomyositis. Rheumatology (Oxford). 2009;48(2):134–9.

    Article  CAS  Google Scholar 

  25. Regardt M, Welin Henriksson E, Alexanderson H, Lundberg IE. Patients with polymyositis or dermatomyositis have reduced grip force and health-related quality of life in comparison with reference values: an observational study. Rheumatology (Oxford). 2011;50(3):578–85.

    Article  Google Scholar 

  26. Regardt M, Welin Henriksson E, Sandqvist J, Lundberg IE, Schult ML. Work ability in patients with polymyositis and dermatomyositis: An explorative and descriptive study. Work. 2015;53(2):265–77.

    Article  Google Scholar 

  27. Regardt M, Schult ML, Axelsson Y, Aldehag A, Alexanderson H, Lundberg IE, et al. Hand exercise intervention in patients with polymyositis and dermatomyositis: a pilot study. Musculoskeletal Care. 2014;12(3):160–72.

    Article  Google Scholar 

  28. Cox FM, Titulaer MJ, Sont JK, Wintzen AR, Verschuuren JJ, Badrising UA. A 12-year follow-up in sporadic inclusion body myositis: an end stage with major disabilities. Brain. 2011;134(Pt 11):3167–75.

    Article  Google Scholar 

  29. Lindberg C, Oldfors A. Prognosis and prognostic factors in sporadic inclusion body myositis. Acta Neurol Scand. 2012;125(5):353–8.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Functional Area Occupational Therapy and Physical Therapy, Karolinska University Hospital, Stockholm, Sweden

    Helene Alexanderson & Malin Regardt

  2. Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden

    Helene Alexanderson

  3. Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden

    Malin Regardt

Authors
  1. Helene Alexanderson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Malin Regardt
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Helene Alexanderson .

Editor information

Editors and Affiliations

  1. Division of Rheumatology and Clinical Immunology, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA

    Rohit Aggarwal

  2. Division of Rheumatology and Clinical Immunology, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA

    Chester V. Oddis

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Alexanderson, H., Regardt, M. (2020). Role of Exercise in the Management of Myositis. In: Aggarwal, R., Oddis, C. (eds) Managing Myositis. Springer, Cham. https://doi.org/10.1007/978-3-030-15820-0_33

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-15820-0_33

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-15819-4

  • Online ISBN: 978-3-030-15820-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation