Exercise training in juvenile dermatomyositis
Arthritis Care & Research ,

Omori CH et al. – The authors 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 non–active mild and chronic juvenile dermatomyositis (JDM) with near normal physical function and quality of life.

Methods
  • This was a prospective longitudinal study following 10 children with mild and chronic JDM (disease duration > 1 year).
  • The exercise program consisted of a twice–a–week aerobic and resistance training.
  • At baseline and after the 12–week intervention, they assessed muscle strength and function, aerobic conditioning, body composition, JDM scores, and health–related quality of life.

Results
  • Child self–report and parent proxy–report PedsQL scores were improved after the intervention (–40.3%, p=0.001 and –48.2%, p=0.049, respectively).
  • Importantly, after exercise DAS was reduced (–26.9%, p=0.026) and CMAS was improved (+2.5%, p=0.009), whereas MMT presented a trend towards statistical significance (+2.2%, p=0.081).
  • The V02peak 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–limb 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).

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