620 - Beneficial Effects of Exercise on Inflammatory Myopathies: A Systematic Review

Objectives: Inflammatory myopathies, such as dermatomyositis (DM) or polymyositis (PM), are debilitating diseases that involve chronic muscle inflammation and weakness. Numerous studies note exercise may improve strength, aerobic capacity, inflammation, and quality of life (mental, physical, and social function) in patients with myositis. The purpose of this systematic review was to examine evidence regarding the potential benefits and clinical relevance of various types of exercise on myositis patients.

Design: This is a systematic review study. Electronic databases used were PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and the Physiotherapy Evidence Database (PEDro). The data searched included all published works to date (June 2024). Studies were included if they met both the criteria of myositis diagnosis and exercise intervention.

Results: The results from 24 studies and 324 participants with forms of myositis were assessed. Common outcome measures included muscle biopsies and laboratory analyses to assess inflammatory markers and/or RNA levels, cardiorespiratory assessments, the MDA assessment tool, IMACS myositis response criteria, SF-36, ADLs, manual muscle tests, Myositis Activities Profile, etc.


Conclusions: Exercise, either supervised or unsupervised, may be effective in improving muscle strength, endurance, function, fatigue, aerobic capacity, grip strength, gait speed, pain, cardiopulmonary risk, and quality of life in patients with inflammatory myopathies. Importantly, exercise appears to not increase, and sometimes decrease, muscle inflammation in these patients. Additionally, supporting biochemical analyses suggest activation of aerobic, anti-oxidative, and both anabolic and catabolic metabolic pathways. Exercise may reduce disease activity in these patients and augment the ability to perform daily tasks. However, there is significant variability in the design, intervention parameters, and outcome measures of these studies. Nonetheless, the literature suggests that implementation of exercise regimens can lead to improvement in disease activity, muscle strength, endurance, pain, quality of life. Therefore, physiatrists should coordinate the care of myositis patients accordingly.