4.4 Review

Physical activity in idiopathic inflammatory myopathies: two intervention proposals based on literature review

Journal

CLINICAL RHEUMATOLOGY
Volume 41, Issue 3, Pages 593-615

Publisher

SPRINGER LONDON LTD
DOI: 10.1007/s10067-021-05954-7

Keywords

Dermatomyositis; Exercise; Idiopathic inflammatory myopathies; Inclusion body myositis; Necrotizing myopathy; Physical activity; Polymyositis

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Idiopathic inflammatory myopathies (IIM) are rare diseases affecting skeletal muscles, and the management of IIM has notably improved in recent years with a better understanding of their pathogenesis. Current therapeutic strategies include pharmacological and non-pharmacological interventions, with physical exercise being an effective option to improve disease activity without worsening muscle inflammation. A combined strategy of aerobic exercise and resistance training can positively impact the pro-inflammatory and metabolic pathways in skeletal muscles, while promoting muscle fiber regeneration and repair.
Idiopathic inflammatory myopathies (IIM) are rare diseases affecting skeletal muscles and leading to progressive muscle weakness and disability. Thanks to the better understanding of their pathogenesis, the management of IIM has been noteworthily implemented in recent years. Current therapeutic strategies include pharmacological and non-pharmacological interventions, among which physical exercise represents a useful option, able to ameliorate disease activity without worsening muscle inflammation. The aim of this narrative review is therefore to provide an updated overview of the benefits of physical exercise in patients with IIM and to suggest plausible training programs to be applied in patients with dermatomyositis, polymyositis, necrotizing myopathy, and inclusion body myositis. In this regard, a combined strategy mixing aerobic and resistance exercises could positively affect the pro-inflammatory and metabolic pathways occurring in skeletal muscles, while promoting muscle fiber regeneration and repair.

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