title: Submaximal Exercise Capacity in Juvenile Dermatomyositis after Longterm Disease: The Contribution of Muscle, Lung, and Heart Involvement.
abstract: To compare submaximal exercise capacity in patients with juvenile dermatomyositis (JDM) with controls, and analyze contributions of muscle, heart, and lung impairment in patients.
  
  
  
  Fifty-nine patients with JDM, with a mean 16.9 years after symptom onset, and 59 sex- and age-matched controls completed a 6-min walk test (6MWT) and a timed up and go (TUG) test. Muscle function, disease activity/damage, and health-related quality of life (HRQOL) were assessed by validated tools; heart function by echocardiography and electrocardiography; and lung function by spirometry, DLCO, and body plethysmography. A thoracic high-resolution computed tomography (HRCT) scan and magnetic resonance imaging of the thighs were completed in patients.
  
  
  
  The 6MWT distance (6MWD) was 592 ± 81 m in patients versus 649 ± 79 m in controls (p < 0.001), and 563 ± 75 m in active versus 622 ± 76 m in inactive JDM (p = 0.004). The TUG time was 13.1 ± 2.1 s in patients versus 12.3 ± 2.0 s in controls (p = 0.034), and 13.7 ± 2.2 s in active versus 12.5 ± 1.8 s in inactive JDM (p = 0.028). No statistically significant difference was found between inactive JDM and controls in either test. In patients, the Childhood Myositis Assessment Score influenced the 6MWD and TUG time the most, followed by a low DLCO and HRCT pathology in the 6MWT and forced vital capacity in the TUG test. Medical Outcomes Study Short Form-36 physical component summary correlated strongly with both tests.
  
  
  
  Submaximal exercise capacity was reduced in patients with JDM, particularly those with active disease. This reduction was associated with muscle and lung dysfunction and poorer HRQOL.
authors.affiliation: From the Department of Rheumatology, the Department of Cardiology, the Department of Radiology and Nuclear Medicine, and the Department of Respiratory Medicine, Oslo University Hospital, Rikshospitalet; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo; Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo; Norwegian National Advisory Unit on Rheumatic Diseases in Children and Adolescents, Oslo University Hospital, Rikshospitalet, Oslo, Norway. krisc@medisin.uio.no.|K.S. Berntsen, MD, Department of Rheumatology, Oslo University Hospital, Rikshospitalet; A. Tollisen, RN, MSc, Department of Rheumatology, Oslo University Hospital, Rikshospitalet; T. Schwartz, MD, PhD, Department of Cardiology, Oslo University Hospital, and Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo; E. Kirkhus, MD, PhD, Department of Radiology and Nuclear Medicine, Oslo University Hospital; T.M. Aaløkken, MD, PhD, Department of Radiology and Nuclear Medicine, Oslo University Hospital; M.B. Lund, MD, PhD, Department of Respiratory Medicine, Oslo University Hospital, Rikshospitalet; B. Flatø, MD, PhD, Department of Rheumatology, Oslo University Hospital, Rikshospitalet, and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo; I. Sjaastad, MD, PhD, Department of Cardiology, Oslo University Hospital, and Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo; H. Sanner, MD, PhD, Department of Rheumatology, and Norwegian National Advisory Unit on Rheumatic Diseases in Children and Adolescents, Oslo University Hospital, Rikshospitalet. krisc@medisin.uio.no.
authors.forename: Kristin Schjander
authors.initials: KS
authors.lastname: Berntsen
authors.affiliation: From the Department of Rheumatology, the Department of Cardiology, the Department of Radiology and Nuclear Medicine, and the Department of Respiratory Medicine, Oslo University Hospital, Rikshospitalet; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo; Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo; Norwegian National Advisory Unit on Rheumatic Diseases in Children and Adolescents, Oslo University Hospital, Rikshospitalet, Oslo, Norway.|K.S. Berntsen, MD, Department of Rheumatology, Oslo University Hospital, Rikshospitalet; A. Tollisen, RN, MSc, Department of Rheumatology, Oslo University Hospital, Rikshospitalet; T. Schwartz, MD, PhD, Department of Cardiology, Oslo University Hospital, and Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo; E. Kirkhus, MD, PhD, Department of Radiology and Nuclear Medicine, Oslo University Hospital; T.M. Aaløkken, MD, PhD, Department of Radiology and Nuclear Medicine, Oslo University Hospital; M.B. Lund, MD, PhD, Department of Respiratory Medicine, Oslo University Hospital, Rikshospitalet; B. Flatø, MD, PhD, Department of Rheumatology, Oslo University Hospital, Rikshospitalet, and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo; I. Sjaastad, MD, PhD, Department of Cardiology, Oslo University Hospital, and Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo; H. Sanner, MD, PhD, Department of Rheumatology, and Norwegian National Advisory Unit on Rheumatic Diseases in Children and Adolescents, Oslo University Hospital, Rikshospitalet.
authors.forename: Anita
authors.initials: A
authors.lastname: Tollisen
authors.affiliation: From the Department of Rheumatology, the Department of Cardiology, the Department of Radiology and Nuclear Medicine, and the Department of Respiratory Medicine, Oslo University Hospital, Rikshospitalet; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo; Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo; Norwegian National Advisory Unit on Rheumatic Diseases in Children and Adolescents, Oslo University Hospital, Rikshospitalet, Oslo, Norway.|K.S. Berntsen, MD, Department of Rheumatology, Oslo University Hospital, Rikshospitalet; A. Tollisen, RN, MSc, Department of Rheumatology, Oslo University Hospital, Rikshospitalet; T. Schwartz, MD, PhD, Department of Cardiology, Oslo University Hospital, and Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo; E. Kirkhus, MD, PhD, Department of Radiology and Nuclear Medicine, Oslo University Hospital; T.M. Aaløkken, MD, PhD, Department of Radiology and Nuclear Medicine, Oslo University Hospital; M.B. Lund, MD, PhD, Department of Respiratory Medicine, Oslo University Hospital, Rikshospitalet; B. Flatø, MD, PhD, Department of Rheumatology, Oslo University Hospital, Rikshospitalet, and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo; I. Sjaastad, MD, PhD, Department of Cardiology, Oslo University Hospital, and Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo; H. Sanner, MD, PhD, Department of Rheumatology, and Norwegian National Advisory Unit on Rheumatic Diseases in Children and Adolescents, Oslo University Hospital, Rikshospitalet.
authors.forename: Thomas
authors.initials: T
authors.lastname: Schwartz
authors.affiliation: From the Department of Rheumatology, the Department of Cardiology, the Department of Radiology and Nuclear Medicine, and the Department of Respiratory Medicine, Oslo University Hospital, Rikshospitalet; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo; Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo; Norwegian National Advisory Unit on Rheumatic Diseases in Children and Adolescents, Oslo University Hospital, Rikshospitalet, Oslo, Norway.|K.S. Berntsen, MD, Department of Rheumatology, Oslo University Hospital, Rikshospitalet; A. Tollisen, RN, MSc, Department of Rheumatology, Oslo University Hospital, Rikshospitalet; T. Schwartz, MD, PhD, Department of Cardiology, Oslo University Hospital, and Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo; E. Kirkhus, MD, PhD, Department of Radiology and Nuclear Medicine, Oslo University Hospital; T.M. Aaløkken, MD, PhD, Department of Radiology and Nuclear Medicine, Oslo University Hospital; M.B. Lund, MD, PhD, Department of Respiratory Medicine, Oslo University Hospital, Rikshospitalet; B. Flatø, MD, PhD, Department of Rheumatology, Oslo University Hospital, Rikshospitalet, and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo; I. Sjaastad, MD, PhD, Department of Cardiology, Oslo University Hospital, and Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo; H. Sanner, MD, PhD, Department of Rheumatology, and Norwegian National Advisory Unit on Rheumatic Diseases in Children and Adolescents, Oslo University Hospital, Rikshospitalet.
authors.forename: Eva
authors.initials: E
authors.lastname: Kirkhus
authors.affiliation: From the Department of Rheumatology, the Department of Cardiology, the Department of Radiology and Nuclear Medicine, and the Department of Respiratory Medicine, Oslo University Hospital, Rikshospitalet; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo; Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo; Norwegian National Advisory Unit on Rheumatic Diseases in Children and Adolescents, Oslo University Hospital, Rikshospitalet, Oslo, Norway.|K.S. Berntsen, MD, Department of Rheumatology, Oslo University Hospital, Rikshospitalet; A. Tollisen, RN, MSc, Department of Rheumatology, Oslo University Hospital, Rikshospitalet; T. Schwartz, MD, PhD, Department of Cardiology, Oslo University Hospital, and Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo; E. Kirkhus, MD, PhD, Department of Radiology and Nuclear Medicine, Oslo University Hospital; T.M. Aaløkken, MD, PhD, Department of Radiology and Nuclear Medicine, Oslo University Hospital; M.B. Lund, MD, PhD, Department of Respiratory Medicine, Oslo University Hospital, Rikshospitalet; B. Flatø, MD, PhD, Department of Rheumatology, Oslo University Hospital, Rikshospitalet, and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo; I. Sjaastad, MD, PhD, Department of Cardiology, Oslo University Hospital, and Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo; H. Sanner, MD, PhD, Department of Rheumatology, and Norwegian National Advisory Unit on Rheumatic Diseases in Children and Adolescents, Oslo University Hospital, Rikshospitalet.
authors.forename: Trond Mogens
authors.initials: TM
authors.lastname: Aaløkken
authors.affiliation: From the Department of Rheumatology, the Department of Cardiology, the Department of Radiology and Nuclear Medicine, and the Department of Respiratory Medicine, Oslo University Hospital, Rikshospitalet; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo; Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo; Norwegian National Advisory Unit on Rheumatic Diseases in Children and Adolescents, Oslo University Hospital, Rikshospitalet, Oslo, Norway.|K.S. Berntsen, MD, Department of Rheumatology, Oslo University Hospital, Rikshospitalet; A. Tollisen, RN, MSc, Department of Rheumatology, Oslo University Hospital, Rikshospitalet; T. Schwartz, MD, PhD, Department of Cardiology, Oslo University Hospital, and Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo; E. Kirkhus, MD, PhD, Department of Radiology and Nuclear Medicine, Oslo University Hospital; T.M. Aaløkken, MD, PhD, Department of Radiology and Nuclear Medicine, Oslo University Hospital; M.B. Lund, MD, PhD, Department of Respiratory Medicine, Oslo University Hospital, Rikshospitalet; B. Flatø, MD, PhD, Department of Rheumatology, Oslo University Hospital, Rikshospitalet, and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo; I. Sjaastad, MD, PhD, Department of Cardiology, Oslo University Hospital, and Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo; H. Sanner, MD, PhD, Department of Rheumatology, and Norwegian National Advisory Unit on Rheumatic Diseases in Children and Adolescents, Oslo University Hospital, Rikshospitalet.
authors.forename: May Brit
authors.initials: MB
authors.lastname: Lund
authors.affiliation: From the Department of Rheumatology, the Department of Cardiology, the Department of Radiology and Nuclear Medicine, and the Department of Respiratory Medicine, Oslo University Hospital, Rikshospitalet; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo; Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo; Norwegian National Advisory Unit on Rheumatic Diseases in Children and Adolescents, Oslo University Hospital, Rikshospitalet, Oslo, Norway.|K.S. Berntsen, MD, Department of Rheumatology, Oslo University Hospital, Rikshospitalet; A. Tollisen, RN, MSc, Department of Rheumatology, Oslo University Hospital, Rikshospitalet; T. Schwartz, MD, PhD, Department of Cardiology, Oslo University Hospital, and Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo; E. Kirkhus, MD, PhD, Department of Radiology and Nuclear Medicine, Oslo University Hospital; T.M. Aaløkken, MD, PhD, Department of Radiology and Nuclear Medicine, Oslo University Hospital; M.B. Lund, MD, PhD, Department of Respiratory Medicine, Oslo University Hospital, Rikshospitalet; B. Flatø, MD, PhD, Department of Rheumatology, Oslo University Hospital, Rikshospitalet, and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo; I. Sjaastad, MD, PhD, Department of Cardiology, Oslo University Hospital, and Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo; H. Sanner, MD, PhD, Department of Rheumatology, and Norwegian National Advisory Unit on Rheumatic Diseases in Children and Adolescents, Oslo University Hospital, Rikshospitalet.
authors.forename: Berit
authors.initials: B
authors.lastname: Flatø
authors.affiliation: From the Department of Rheumatology, the Department of Cardiology, the Department of Radiology and Nuclear Medicine, and the Department of Respiratory Medicine, Oslo University Hospital, Rikshospitalet; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo; Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo; Norwegian National Advisory Unit on Rheumatic Diseases in Children and Adolescents, Oslo University Hospital, Rikshospitalet, Oslo, Norway.|K.S. Berntsen, MD, Department of Rheumatology, Oslo University Hospital, Rikshospitalet; A. Tollisen, RN, MSc, Department of Rheumatology, Oslo University Hospital, Rikshospitalet; T. Schwartz, MD, PhD, Department of Cardiology, Oslo University Hospital, and Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo; E. Kirkhus, MD, PhD, Department of Radiology and Nuclear Medicine, Oslo University Hospital; T.M. Aaløkken, MD, PhD, Department of Radiology and Nuclear Medicine, Oslo University Hospital; M.B. Lund, MD, PhD, Department of Respiratory Medicine, Oslo University Hospital, Rikshospitalet; B. Flatø, MD, PhD, Department of Rheumatology, Oslo University Hospital, Rikshospitalet, and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo; I. Sjaastad, MD, PhD, Department of Cardiology, Oslo University Hospital, and Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo; H. Sanner, MD, PhD, Department of Rheumatology, and Norwegian National Advisory Unit on Rheumatic Diseases in Children and Adolescents, Oslo University Hospital, Rikshospitalet.
authors.forename: Ivar
authors.initials: I
authors.lastname: Sjaastad
authors.affiliation: From the Department of Rheumatology, the Department of Cardiology, the Department of Radiology and Nuclear Medicine, and the Department of Respiratory Medicine, Oslo University Hospital, Rikshospitalet; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo; Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo; Norwegian National Advisory Unit on Rheumatic Diseases in Children and Adolescents, Oslo University Hospital, Rikshospitalet, Oslo, Norway.|K.S. Berntsen, MD, Department of Rheumatology, Oslo University Hospital, Rikshospitalet; A. Tollisen, RN, MSc, Department of Rheumatology, Oslo University Hospital, Rikshospitalet; T. Schwartz, MD, PhD, Department of Cardiology, Oslo University Hospital, and Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo; E. Kirkhus, MD, PhD, Department of Radiology and Nuclear Medicine, Oslo University Hospital; T.M. Aaløkken, MD, PhD, Department of Radiology and Nuclear Medicine, Oslo University Hospital; M.B. Lund, MD, PhD, Department of Respiratory Medicine, Oslo University Hospital, Rikshospitalet; B. Flatø, MD, PhD, Department of Rheumatology, Oslo University Hospital, Rikshospitalet, and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo; I. Sjaastad, MD, PhD, Department of Cardiology, Oslo University Hospital, and Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo; H. Sanner, MD, PhD, Department of Rheumatology, and Norwegian National Advisory Unit on Rheumatic Diseases in Children and Adolescents, Oslo University Hospital, Rikshospitalet.
authors.forename: Helga
authors.initials: H
authors.lastname: Sanner
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003882:Dermatomyositis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D004452:Echocardiography; D004562:Electrocardiography; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D006304:Health Status; D006321:Heart / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011788:Quality of Life; D014057:Tomography, X-Ray Computed; D014797:Vital Capacity; D055815:Young Adult
keywords: 6-MIN WALK TEST; FUNCTIONAL CAPACITY; JUVENILE DERMATOMYOSITIS; LONGTERM DISEASE; SUBMAXIMAL EXERCISE TESTING; TIMED UP AND GO