Effectiveness of physical training on physical performance in patients with dermatomyositis and polymyositis

systematic review and meta-analysis

Authors

DOI:

https://doi.org/10.1590/1809-2950/21001328032021

Abstract

This study aimed to evaluate the impact of
physical training on physical performance in patients with
dermatomyositis and polymyositis. For this purpose, we
conducted a systematic review and meta-analysis according
to the guidelines of PRISMA (Preferred Reporting Items
for Systematic Reviews and Meta-Analyses). The literature
search was conducted in the following databases: PubMed/
MEDLINE and Web of Science, using combinations of
the following keywords in English: dermatomyositis OR
polymyositis OR myositis AND exercise OR physical exercise
OR physical therapy OR aerobic exercise OR endurance
exercise OR resistance exercise. Studies that met the
following criteria were included: (1) participants diagnosed with dermatomyositis or polymyositis; (2) patients that undergone
a physical training protocol; (3) physical performance measured
before and after the physical training protocol. A total of 14 articles
were selected for inclusion in the systematic review and 10 articles
were selected for inclusion in the meta-analysis. The outcomes
demonstrate that physical training is effective in increasing
overall physical performance in patients with dermatomyositis
and polymyositis (effect size: 0.72; 95% CI 0.55; 0.89). Also, our
study demonstrated that both the aerobic performance (effect
size: 0.88; 95% CI 0.54; 1.21) and resistance performance variables
(effect size: 0.64; CI 95% 0.43; 0.85) benefit from physical training in
these patients. We concluded that physical training had a significant
beneficial effect on the overall, aerobic and resistance physical
performance in patients with dermatomyositis and polymyositis

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References

Alexanderson H. Exercise in Myositis. Curr Treatm Opt

Rheumatol. 2018;4(4):289-98. doi: 10.1007/s40674-018-0113-3.

Pipitone N, Salvarani C. Treatment of inflammatory

myopathies. Expert Rev Clin Immunol. 2018;14(7):607-21. doi:

1080/1744666X.2018.1491307.

Findlay AR, Goyal NA, Mozaffar T. An overview of polymyositis

and dermatomyositis. Muscle Nerve. 2015;51(5):638-56. doi:

1002/mus.24566.

Ortigosa LCM, Reis VMS. Dermatomiosite. Anais

Brasileiros de Dermatologia. 2008;83:247-59. doi: 10.1590/

S0365-05962008000300010.

Bohan A, Peter JB. Polymyositis and dermatomyositis (first

of two parts). N Engl J Med. 1975;292(7):344-7. doi: 10.1056/

NEJM197502132920706.

Bohan A, Peter JB. Polymyositis and dermatomyositis (second

of two parts). N Engl J Med. 1975;292(8):403-7. doi: 10.1056/

NEJM197502202920807.

Drake LA, Dinehart SM, Farmer ER, Goltz RW, Graham GF,

Hordinsky MK, et al. Guidelines of care for dermatomyositis.

American Academy of Dermatology. J Am Acad Dermatol

[Internet]. 1996 [cited 2021 Sep 29];34(5 Pt 1):824-9. Available

from: https://bit.ly/3zMRA3N

Diaz MTM, Fraga PS, Silva MG, Shinjo SK. Muscle biopsies

in dermatomyositis and polymyositis: practical relevance of

analyzing different levels of histological sections of the same

muscular compartment. J Bras Patol Med Lab. 2017;53:196-201.

doi: 10.5935/1676-2444.20170031.

Cobos GA, Femia A, Vleugels RA. Dermatomyositis: an

update on diagnosis and treatment. Am J Clin Dermatol.

;21(3):339-353. doi: 10.1007/s40257-020-00502-6.

Sasaki H, Kohsaka H. Current diagnosis and treatment

of polymyositis and dermatomyositis. Mod Rheumatol.

;28(6):913-21. doi: 10.1080/14397595.2018.1467257.

Sousa DPN, Lombardi I Jr. Avaliação da capacidade aeróbia

e exercícios resistidos em pacientes com dermatomiosite e

polimiosite juvenil: revisão de literatura. Fisioter Mov [Internet].

[cited 2021 Sep 29];22(4):489-96. Available from: https://

bit.ly/3odTI2D

Painelli VS, Gualano B, Artioli GG, Sa Pinto AL, Bonfa E, Lancha

AH Jr, et al. The possible role of physical exercise on the

treatment of idiopathic inflammatory myopathies. Autoimmun

Rev. 2009;8(5):355-9. doi: 10.1016/j.autrev.2008.11.008.

Alexanderson H. Exercise effects in patients with adult

idiopathic inflammatory myopathies. Curr Opin Rheumatol.

;21(2):158-63. doi: 10.1097/BOR.0b013e328324e700.

Alexanderson H. Exercise in inflammatory myopathies, including

inclusion body myositis. Curr Rheumatol Rep. 2012;14(3):244-51.

doi: 10.1007/s11926-012-0248-4.

Alexanderson H, Lundberg IE. Exercise as a therapeutic

modality in patients with idiopathic inflammatory myopathies.

Curr Opin Rheumatol. 2012;24(2):201-7. doi: 10.1097/

BOR.0b013e32834f19f5.

Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA

Group. Preferred reporting items for systematic reviews

and meta-analyses: the PRISMA statement. PLoS Med.

;6(7):e1000097. doi: 10.1371/journal.pmed.1000097.

Higgins JPT, Green S, editors. Cochrane handbook for

systematic reviews of interventions [Internet]. [cited 2021

Sep 29]. London: The Cochrane Collaboration; 2011. Available

from: https://bit.ly/3zT5oKa

Cohen J. Statistical power analysis for the behavioral sciences.

nd ed. Hillsdale: Lawrence Earlbaum Associates; 1988.

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.

;15(4):R83. doi: 10.1186/ar4263.

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).

;65(12):1959-68. doi: 10.1002/acr.22068.

Alemo-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. doi: 10.1002/art.39624.

Alexanderson H, Stenstrom CH, Lundberg I. Safety of a

home exercise programme in patients with polymyositis

and dermatomyositis: a pilot study. Rheumatology (Oxford).

;38(7):608-11. doi: 10.1093/rheumatology/38.7.608.

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. doi: 10.1002/art.22780.

Habers GE, Bos GJ, van Royen-Kerkhof A, Lelieveld OT,

Armbrust W, Takken T, et al. Muscles in motion: a randomized

controlled trial on the feasibility, safety and efficacy of an

exercise training programme in children and adolescents

with juvenile dermatomyositis. Rheumatology (Oxford).

;55(7):1251-62. doi: 10.1093/rheumatology/kew026.

Mattar MA, Gualano B, Perandini LA, Shinjo SK, Lima FR, SaPinto AL, et al. Safety and possible effects of low-intensity

resistance training associated with partial blood flow restriction

in polymyositis and dermatomyositis. Arthritis Res Ther.

;16(5):473. doi: 10.1186/s13075-014-0473-5.

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. doi: 10.2119/

molmed.2010.00016.

Oliveira DS, Borges IBP, Souza JM, Gualano B, Pereira RMR,

Shinjo SK. Exercise training attenuates insulin resistance

and improves beta-cell function in patients with systemic

autoimmune myopathies: a pilot study. Clin Rheumatol.

;38(12):3435-42. doi: 10.1007/s10067-019-04738-4.

Omori CH, Silva CAA, Sallum AME, Pereira RMR, Pinto ALS,

Roschel H, et al. Exercise training in juvenile dermatomyositis.

Arthritis Care Res (Hoboken). 2012;64(8):1186-94. doi: 10.1002/

acr.21684.

Riisager M, Mathiesen PR, Vissing J, Preisler N, Orngreen MC.

Aerobic training in persons who have recovered from juvenile

dermatomyositis. Neuromuscul Disord. 2013;23(12):962-8. doi:

1016/j.nmd.2013.09.002.

Varju C, Petho E, Kutas R, Czirjak L. The effect of physical

exercise following acute disease exacerbation in patients

with dermato/polymyositis. Clin Rehabil. 2003;17(1):83-7. doi:

1191/0269215503cr572oa.

Wiesinger GF, Quittan M, Graninger M, Seeber A, Ebenbichler G,

Sturm B, et al. Benefit of 6 months long-term physical training

in polymyositis/dermatomyositis patients. Br J Rheumatol.

;37(12):1338-42. doi: 10.1093/rheumatology/37.12.1338.

Wiesinger GF, Quittan M, Aringer M, Seeber A, Volc-Platzer B,

Smolen J, et al. Improvement of physical fitness and muscle

strength in polymyositis/dermatomyositis patients by a training

programme. Br J Rheumatol. 1998;37(2):196-200. doi: 10.1093/

rheumatology/37.2.196.

Souza FHC, Araujo DB, Vilela VS, Bezerra MC, Simoes RS,

Bernardo WM, et al. Guidelines of the Brazilian Society of

Rheumatology for the treatment of systemic autoimmune

myopathies. Adv Rheumatol. 2019;59(1):6. doi: 10.1186/

s42358-019-0048-x

Published

2023-02-23

Issue

Section

Revisão Sistemática

How to Cite

Effectiveness of physical training on physical performance in patients with dermatomyositis and polymyositis: systematic review and meta-analysis. (2023). Fisioterapia E Pesquisa, 28(3), 331-342. https://doi.org/10.1590/1809-2950/21001328032021