Aerobic training in persons who have recovered from juvenile dermatomyositis |
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| Authors: | M Riisager PR Mathiesen J Vissing N Preisler MC Ørngreen |
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| Institution: | 1. Neuromuscular Research Unit, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark;2. Department of Pediatrics, Holbæk Hospital, Denmark;1. Groupe de recherche interdisciplinaire en maladies neuromusculaires (GRIMN), Centre de santé et de services sociaux de Jonquière, Québec, Canada;2. Faculty of Medicine and Health Sciences, Université de Sherbrooke, Québec, Canada;3. Department of Neurology, University of Milan, IRCCS Policlinico San Donato, Italy;4. Human Genetics Unit, Centre hospitalier de l’Université Laval, Québec, Canada;5. ÉCOBES, Cégep de Jonquière, Québec, Canada;6. Centre hospitalier universitaire de Chicoutimi, Chicoutimi, Québec, Canada;7. Department of Health Sciences, Université du Québec à Chicoutimi, Québec, Canada;8. Faculty of Medicine, Université Laval, Québec, Canada;9. Canadian Forces Health Services HQ, Directorate of Medical Policy, Québec, Canada;1. Inserm, U975, Centre de recherche de l’Institut du Cerveau et de la Moelle Épinière (CRICM), Groupe hospitalier Pitié-Salpêtrière, Paris, France;2. Université Pierre et Marie Curie Paris 6, UMRS975, Paris, France;3. CNRS, UMR7225, Paris, France;4. Ecole Pratique des Hautes Etudes, Paris, France;5. Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, London, UK;6. Inserm, U952, Paris, France;7. CNRS, UMR7224, Paris, France;8. Université Pierre et Marie Curie Paris 6, UMRS952, Paris, France;9. Institut de Myologie, Unité de Morphologie Neuromusculaire, Groupe Hospitalier Pitié-Salpêtrière, Paris, France;10. AP-HP, Groupe hospitalier Pitié-Salpêtrière, Paris, France;11. Service de Neurologie, Fondation Ophtalmologique Rothschild, Paris, France;1. Department of Paediatric Neurology – Neuromuscular Service, Evelina Children’s Hospital, St Thomas’ Hospital, London, UK;2. Randall Division for Cell and Molecular Biophysics, Muscle Signalling Section, London, UK;3. Clinical Neuroscience Division, King’s College, London, UK;4. Department of Medical Genetics, Haartman Institute, University of Helsinki, Biomedicum Helsinki, Finland;5. The Folkhälsan Department of Medical Genetics, Helsinki, Finland;6. Department of Translational Medecine and Neurogenetics, IGBMC (Institut de Génétique et de Biologie Moléculaire et Cellulaire), Illkirch F-67404, France;7. Inserm, U964, Illkirch F-67404, France;8. CNRS, UMR7104, Illkirch F-67404, France;9. Université de Strasbourg, Strasbourg F-67404, France;10. Collège de France, Illkirch F-67404, France;1. Unité de Morphologie Neuromusculaire, Institut de Myologie, Groupe Hospitalier Universitaire La Pitié-Salpêtrière, Paris, France;2. Department of Neurological, Neurosurgical, and Behavioral Sciences, University of Siena, Siena, Italy;3. Inserm, U974, Paris F-75013, France;4. Université Pierre et Marie Curie-Paris 6, UM 76, CNRS, UMR 7215, Institut de Myologie, IFR14, Paris F-75013, France;5. Centre de Référence de Pathologie Neuromusculaire Paris-Est, Institut de Myologie, GHU La Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France;6. Department of Translational Medicine and Neurogenetics, IGBMC, Illkirch, France;7. Inserm, U964, Illkirch, France;8. CNRS, UMR7104, Illkirch, France;9. Université de Strasbourg, Illkirch, France;10. Collège de France, Chaire de Génétique Humaine, Illkirch, France;11. CHU de Caen, Centre de Compétences des Pathologies Neuro-musculaires, Côte de Nacre, INSERM U 1075 COMETE, 14033 CAEN Cedex, France;12. BGI-Shenzhen, Shenzhen 518083, China;1. MRC Centre for Neuromuscular Disease, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK;2. Oxford MDC Muscle and Nerve Centre, West Wing, John Radcliffe Hospital, Oxford, UK;3. Institute of Genetic Medicine, Newcastle University, International Centre for Life, Central Parkway, Newcastle upon Tyne NE1 3BZ, UK;1. Australian Neuro-Muscular Research Institute, Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia;2. Institute for Immunology & Infectious Diseases, Murdoch University, Western Australia, Australia;3. Departments of Neurology and Neurophysiology, Royal Melbourne Hospital & Department of Medicine, University of Melbourne, Parkville, Victoria, Australia;4. Department of Neurology, Concord Hospital, Concord, NSW, Australia;5. Duke University, Durham, NC 27705, USA;6. Zinfandel Pharmaceuticals, Durham, NC 27705, USA |
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| Abstract: | A recent study has shown that 36 persons who had recovered from juvenile dermatomyositis (JDM) have on average an 18% decrease in maximal oxygen uptake. The objective of this study was to investigate the effect of a 12-week aerobic training program in this group, and assess whether aerobic training can normalize aerobic capacity to the expected level for age and gender.The patients participating in the study, one male and nine females (16–42 years of age), were in remission from JDM, defined as no clinical or biochemical evidence of disease activity and no medical treatment for 1 year. The patients had a median disease duration of 3.4 years (1.4–10.3), a median treatment duration of 2.4 years (0.4–9.3) and a median duration of remission of 7.0 years (1.2–30.0).Patients trained at home on a cycle ergometer for 12 weeks at a heart rate interval corresponding to 65% of their maximal oxygen uptake (VO2max). VO2max and maximal workload (Wmax) were determined before and after the 12-week training period through an incremental cycling test to exhaustion. The patients served as their own controls.Eight patients with JDM in remission completed the 12-week exercise program; one patient completed 9 weeks out of the 12-week program and one dropped out of the study. Training increased VO2max and Wmax by 26% and 30% (P < 0.001). Creatine kinase (CK) levels were normal pre-training and did not change with training, reflecting no muscle damage. We also found that at a given workload, heart rate was lowered significantly after the 12-week training period, indicating an improvement in cardiovascular fitness.This study shows that 12 weeks of moderate-intensity aerobic training is an effective and safe method to increase oxidative capacity and fitness in persons who have recovered from JDM. The results indicate that the low oxidative capacity in JDM patients in remission is reversible and can be improved. Thus, we recommend frequent aerobic training to be incorporated into supervised physiotherapy sessions in the treatment of JDM patients in remission. |
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| Keywords: | Juvenile dermatomyositis Fitness Aerobic training Cycling Maximal oxidative capacity Creatine kinase |
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