title: 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.
abstract: OBJECTIVE
  To determine the effects of a 12-week endurance exercise program on health, disability, VO2 max, and disease activity in a multicenter randomized controlled trial in patients with established polymyositis (PM) and dermatomyositis (DM), and to evaluate health and disability in a 1-year open extension study.
  
  
  METHODS
  Patients were randomized into a 12-week endurance exercise program group (EG; n = 11) or a control group (CG; n = 10). Assessments of health (Short Form 36 [SF-36]), muscle performance (5 voluntary repetition maximum [5 VRM]), activities of daily living (ADL), patient preference (McMaster Toronto Arthritis Patient Preference Disability Questionnaire), VO2 max, and disease activity (International Myositis Assessment and Clinical Studies criteria of improvement of the 6-item core set) were performed at 0 and 12 weeks. Disability assessments were performed again at 52 weeks in an open extension period. All assessments were performed by blinded observers.
  
  
  RESULTS
  The EG improved compared to the CG in SF-36 physical function and vitality (P = 0.010 and P = 0.046, respectively), ADL score (P = 0.035), 5 VRM (P = 0.026), and VO2 max (P = 0.010). More patients in the EG (7 of 11) were responders with reduced disease activity compared to none in the CG (P = 0.002). Correlations between VO2 max and SF-36 physical function were 0.90 and 0.91 at 0 and 12 weeks, respectively (P < 0.05). The EG improvement in 5 VRM was sustained up to 52 weeks compared to baseline (5.7 kg; P < 0.001), but not in ADL score or SF-36.
  
  
  CONCLUSIONS
  Endurance exercise improves health and may reduce disease activity in patients with established PM/DM. This potentially could be mediated through improved aerobic fitness. The results also indicate sustained muscle strength up to 1 year after a supervised program.
authors.affiliation: Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Li
authors.initials: L
authors.lastname: Alemo Munters
authors.forename: Maryam
authors.initials: M
authors.lastname: Dastmalchi
authors.forename: Vivianne
authors.initials: V
authors.lastname: Andgren
authors.forename: Christina
authors.initials: C
authors.lastname: Emilson
authors.forename: Jenny
authors.initials: J
authors.lastname: Bergegård
authors.forename: Malin
authors.initials: M
authors.lastname: Regardt
authors.forename: Anna
authors.initials: A
authors.lastname: Johansson
authors.forename: Ingrid
authors.initials: I
authors.lastname: Orefelt Tholander
authors.forename: Balsam
authors.initials: B
authors.lastname: Hanna
authors.forename: Maria
authors.initials: M
authors.lastname: Lidén
authors.forename: Mona
authors.initials: M
authors.lastname: Esbjörnsson
authors.forename: Helene
authors.initials: H
authors.lastname: Alexanderson
mesh_terms: D000203:Activities of Daily Living; D003882:Dermatomyositis / Q000503:physiopathology / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D057240:Patient Preference; D010807:Physical Endurance; D011795:Surveys and Questionnaires; D016896:Treatment Outcome