Session Information
Date: Sunday, October 21, 2018
Title: Muscle Biology, Myositis and Myopathies Poster I: Clinical Features and Disease Course
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: Muscle inflammation and weakness, subsequent atrophy and permanent muscle damage in idiopathic inflammatory myopathies (IIM) lead to impaired function, reduced muscle strength, endurance and aerobic capacity, decreasing quality of life. Data on the effectiveness of non-pharmacological care in IIM are limited due to heterogeneity of studied interventions/outcomes. The aim of our study was to minimalize the limitations of available studies and to determine the effect of an intensive exercise program on muscle strength and endurance and the quality of life in cohorts with a substantial number of IIM patients.
Methods: All patients were non-selectively consecutively recruited into intervention (IG) and control (CG) group and they had impaired skeletal muscle strength. They fulfilled the Bohan and Peter 1975 diagnostic criteria. Patients from both groups received educational material for home exercises, but only the IG underwent a six-month intensive ADL (activities of daily living) and muscle strength exercise program with a subsequent six-month follow-up period. All patients were evaluated by a physician and physiotherapist blinded to intervention at 0, 3, 6 and 12 months. Patients also filled out patient reported outcomes/questionnaires and provided blood for routine laboratory analysis and biobanking. Data analysis was performed between groups and within the group.
Results: In total 27 patients were included in the IG and 23 patients in the CG. Compared to the observed statistically significant deterioration in the CG over the period of 0-6 months, we found a statistically significant improvement in IG in objectively assessed muscle strength and endurance as well as in subjectively assessed functional abilities (HAQ) and depression (BDI-II). During the follow-up period, there was a significant deterioration or stagnation of the achieved results in the IG. However, improved functional abilities during the intervention period persisted in the IG even in the follow-up period. Only numerical improvements in the IG compared to numerical deterioration in CG, that did not achieve statistical significance, during the intervention period, were observed in some subjectively assessed patient reported outcomes assessing quality of life and fatigue.
Conclusion: Our program led to a significant improvement in the observed parameters that was clinically significant in a substantial proportion of patients (in the IG) and prevention of the expected worsening in muscle strength and endurance (observed in the CG).
Acknowledgments: The project was supported by AZV-16-33574A, SVV for FTVS UK 2019-260466, MHCR 023728
|
Parameter (unit) |
Intervention group Mean ± SEM |
Control group Mean ± SEM |
Intra-group analysis (Friedman+Dunn) |
Inter-group analysis (2WA) |
|
|
Interevention gr. |
Control group |
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|
MMT8 |
m0: 54.7 ± 2.6 |
m0: 63.6 ± 2.0 |
m0-3: p<0.01 |
m0-3: p<0.05 |
p<0.0001 |
|
m3: 60.7 ± 2.4 |
m3: 57.9 ± 1.8 |
m3-6: p<0.0001 |
m3-6: NS |
||
|
m6: 69.1 ± 1.9 |
m6: 54.2 ± 1.9 |
m0-6: p<0.0001 |
m0-6: p<0.0001 |
||
|
m12: 64.0 ± 2.5 |
m12: 56.5 ± 2.2 |
m6-12: p<0.05 |
m6-12:NS |
||
|
FI-2 (%) |
m0: 30.0 ± 4.4 |
m0: 38.3 ± 5.3 |
m0-3: p<0.01 |
m0-3: NS |
p<0.0001 |
|
m3: 46.9 ± 4.7 |
m3: 29.6 ± 4.6 |
m3-6: p<0.0001 |
m3-6: NS |
||
|
m6: 70.6 ± 4.9 |
m6: 26.1 ± 4.1 |
m0-6: p<0.0001 |
m0-6: p<0.01 |
||
|
m12: 58.4 ± 5.8 |
m12: 25.7 ± 3.6 |
m6-12: p<0.05 |
m6-12: NS |
||
|
HAQ |
m0: 0.9 ± 0.2 |
m0: 1.3 ± 0.2 |
m0-3: NS |
m0-3: NS |
p=0.0002 |
|
m3: 0.7 ± 0.1 |
m3: 1.4 ± 0.2 |
m3-6: NS |
m3-6: NS |
||
|
m6: 0.6 ± 0.1 |
m6: 1.4 ± 0.2 |
m0-6: p<0.01 |
m0-6: NS |
||
|
m12: 0.8 ± 0.2 |
m12: 1.5 ± 0.2 |
m6-12: p<0.05 |
m6-12: NS |
||
|
BDI-II |
m0: 11.9 ± 2.1 |
m0: 13.0 ± 1.4 |
m0-3: NS |
m0-3: NS |
p=0.0025 |
|
m3: 10.7 ± 1.7 |
m3: 14.3 ± 1.7 |
m3-6: NS |
m3-6: NS |
||
|
m6: 8.9 ± 1.5 |
m6: 15.7 ± 1. |
m0-6: p<0.05 |
m0-6: NS |
||
|
m12: 10.5 ± 2.0 |
m12: 16.0 ± 2.0 |
m6-12: NS |
m6-12: NS |
||
|
Acronyms: SEM, standard error of the mean; Friedman, Friedman’s test; Dunn, Dunn’s post hoc test; 2WA, two way ANOVA, MMT-8, Manual muscle test-8; FI-2, Functional index-2; HAQ, Health assessment questionnaire; BDI-II, Beck’s depression inventory-II; m0, month 0 (= at the baseline); m3, month 3 (= in the middle of the intervention period); m6, month 6 (= at the end of intervention); m12, month 12 (= at the end of a 6-month follow up period); p, p-value; NS, not significant |
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To cite this abstract in AMA style:
Spiritovic M, Oreska S, Storkanova H, Hermankova B, Cesak P, Rathouska A, Kubinova K, Klein M, Vernerova L, Ruzickova O, Mann HF, Pavelka K, Šenolt L, Vencovsky J, Tomcik M. The Effect of an Intensive Controlled 6-Moth Exercise Program with Subsequent 6-Month Follow-up Period in Patients with Idiopathic Inflammatory Myopathies – Preliminary Data [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/the-effect-of-an-intensive-controlled-6-moth-exercise-program-with-subsequent-6-month-follow-up-period-in-patients-with-idiopathic-inflammatory-myopathies-preliminary-data/. Accessed .« Back to 2018 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-effect-of-an-intensive-controlled-6-moth-exercise-program-with-subsequent-6-month-follow-up-period-in-patients-with-idiopathic-inflammatory-myopathies-preliminary-data/