title: Exercise training in juvenile dermatomyositis.
abstract: OBJECTIVE
  To investigate the effects of a supervised exercise training program on health parameters, physical capacity, and health-related quality of life in patients with mild and chronic juvenile dermatomyositis (DM).
  
  
  METHODS
  This was a prospective longitudinal study following 10 children with mild and chronic juvenile DM (disease duration >1 year). The exercise program consisted of twice-a-week aerobic and resistance training. At baseline and after the 12-week intervention, we assessed muscle strength and function, aerobic conditioning, body composition, juvenile DM scores, and health-related quality of life.
  
  
  RESULTS
  Child self-report and parent proxy-report Pediatric Quality of Life Inventory scores were improved after the intervention (-40.3%; P = 0.001 and -48.2%; P = 0.049, respectively). Importantly, after exercise, the Disease Activity Score was reduced (-26.9%; P = 0.026) and the Childhood Muscle Assessment Scale was improved (+2.5%; P = 0.009), whereas the Manual Muscle Test presented a trend toward statistical significance (+2.2%; P = 0.081). The peak oxygen consumption and time-to-exhaustion were increased by 13.3% (P = 0.001) and 18.2% (P = 0.003), respectively, whereas resting heart rate was decreased by 14.7% (P = 0.006), indicating important cardiovascular adaptations to the exercise program. Upper and lower extremity muscle strength and muscle function were also significantly improved after the exercise training (P < 0.05). Both the whole-body and the lumbar spine bone mineral apparent density were significantly increased after training (1.44%; P = 0.044 and 2.85%; P = 0.008, respectively).
  
  
  CONCLUSIONS
  We showed for the first time that a 12-week supervised exercise program is safe and can improve muscle strength and function, aerobic conditioning, bone mass, disease activity, and health-related quality of life in patients with active and nonactive mild and chronic juvenile DM with near normal physical function and quality of life.
authors.affiliation: University of Sao Paulo, Brazil.
authors.forename: Clarissa Harumi
authors.initials: CH
authors.lastname: Omori
authors.forename: Clovis Artur Almeida
authors.initials: CA
authors.lastname: Silva
authors.forename: Adriana Maluf Elias
authors.initials: AM
authors.lastname: Sallum
authors.forename: Rosa Maria
authors.initials: RM
authors.lastname: Rodrigues Pereira
authors.forename: Ana
authors.initials: A
authors.lastname: Lúciade Sá Pinto
authors.forename: Hamilton
authors.initials: H
authors.lastname: Roschel
authors.forename: Bruno
authors.initials: B
authors.lastname: Gualano
mesh_terms: D000293:Adolescent; D002648:Child; D002908:Chronic Disease; D003882:Dermatomyositis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D015444:Exercise / Q000502:physiology* / Q000523:psychology; D005081:Exercise Therapy / Q000379:methods* / Q000523:psychology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010257:Paraneoplastic Syndromes / Q000523:psychology / Q000628:therapy*; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology; D055070:Resistance Training / Q000379:methods*