Physical exercise among patients with systemic autoimmune myopathies

Oliveira, Diego Sales de; Misse, Rafael Giovani; Lima, Fernanda Rodrigues; Shinjo, Samuel Katsuyuki

doi:10.1186/s42358-018-0004-1

person Diego Sales de Oliveira

schoolDivision of Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Av. Dr. Arnaldo, 455, 3° andar, sala 3150 - Cerqueira César, Sao Paulo 01246-903, Brazil

person Rafael Giovani Misse

schoolDivision of Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Av. Dr. Arnaldo, 455, 3° andar, sala 3150 - Cerqueira César, Sao Paulo 01246-903, Brazil

person Fernanda Rodrigues Lima

schoolDivision of Rheumatology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil

person Samuel Katsuyuki Shinjo *

schoolDivision of Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Av. Dr. Arnaldo, 455, 3° andar, sala 3150 - Cerqueira César, Sao Paulo 01246-903, Brazil

person* Correspondence:
samuel.shinjo@gmail.com

Authors' contributions

All authors contributed equally to write and review the manuscript. All authors read and approved the final manuscript.

Competing interests

The authors declare that they have no competing interests.

Term	Concept
Aerobic capacity	Maximum capacity of the individual to capture oxygen from the environment, transport it through the bloodstream, and use it in cellular respiration. It can be estimated using peak oxygen consumption (peak VO₂) via ergospirometry
Aerobic training	Training characterized by low and moderate intensity efforts with a prolonged duration (over 150 s). This training predominantly uses oxygen (O₂)-dependent bioenergetic pathways to meet the energy demand required by the activity
1RM	Test used to determine the maximum muscle strength of the individual, determined as the maximum amount of weight lifted in only one repetition during a standardized exercise
MVC	Test used to determine the maximum number of repetitions/contractions that the participant can perform with a preset load
Strength training	Training that uses exercises requiring a level of strength above that used in everyday tasks to increase muscle function. When prescribing this training, the 1RM and/or MVC test is necessary, and the training is based on the percentage of each participant's 1RM (usually between 50 and 80% of 1RM/MVC)
Isometric exercise	During this exercise, the production of muscle tension equals the external load imposed on the muscle. Moreover, this exercise is characterized by the absence of joint movement during its execution
Dynamic exercise	This exercise involves the displacement of the body in time and space, and it is characterized by alternations between eccentric and concentric contractions

Author	Patients (n)	Protocol (Exercises)	Time (week)	Evaluated Components	Inflammatory markers	Results
Hicks et al. [⁸]	1	Isometric strength	4	Isometric strength 3 MVC	↔ CPK	↑ Isometric strength
Wiesinger et al. [¹⁰]	14	Aerobic	6	VO₂ peak Isometric strength Activities of daily living	↔ CPK	T VO₂ peak ↑ Isometric strength ↑ Activities of daily living
Wiesinger et al. [¹⁹]	13	Aerobic	24	VO₂ peak Isometric strength Activities of daily living	↔ CPK	↑ VO₂ peak ↑ Isometric strength ↑ Activities of daily living
Alexanderson et al. [²³]	10	Strength Dynamic	12	Muscle function Walking distance Quality of life	↔ CPK ↔ Immune /inflammatory markers	↑ Muscle function ↑ Walking distance ↑ Quality of life
aHeikkilä et al. [⁴⁴]	22	Strength Dynamic	3	Functional capacity Pain	↔ CPK	↑ Muscle function ↔ Pain
bVarvu et al. [⁴⁵]	19	Strength Dynamic	3	Respiratory function (Spirometry) Muscle strength	↔ CPK	↑ Respiratory function ↑ Muscle function
Harris-Love et al. [⁴⁶]	1	Strength Eccentric	12	Isometric strength	↔ Muscle enzymes	↑ Isometric strength ↑ Concentric strength
Alexanderson et al. [²³]	8	Strength Dynamic	7	10-15 MVC Functional capacity	↔ CPK	↑ 10-15 MVC ↑ Disease activity ↑ Functional capacity
Dastmalchi et al. [¹⁴]	9	Aerobic Strength	12	Type of muscle fiber Quality of life Functional capacity	Not reported	↑ Type I Fiber ↑ Functional Capacity ↑ Quality of Life
Chung et al. [⁴⁷]	37	Strength Dynamic Creatine supplementation	20	Functional capacity Muscle strength Quality of life Pain and fatigue Anxiety and depression	↔ CPK	↑ Functional capacity ↑ Muscle strength ↔ Quality of life ↔ Anxiety and depression ↔ Pain and fatigue
Nader et al. [²¹]	8	Strength Dynamic	7	Genes related to inflammation and fibrosis	↓ CPK	↓ Genes related to inflammation and fibrosis ↓ Tissue fibrosis
Munters et al. [¹²]	9	Aerobic	12	Aerobic capacity Activity of mitochondrial enzymes	↔ CPK	↑ Aerobic capacity ↑ Activity of mitochondrial enzymes
Munters et al. [²⁰]	11	Aerobic	12	Aerobic capacity Disability Disease activity Quality of life 5 MVC	↔ CPK	↓ Disease activity ↑ Muscle strength ↑ Quality of life ↑ Aerobic capacity ↑ Quality of life
Mattar et al. [²⁵]	13	Strength Dynamic Vascular occlusion	12	Muscle strength Functional capacity Quality of life	↔ CPK ↔ Aldolase	↑ Muscle strength ↑ Functional capacity ↑ Quality of life
Munters et al. [²²]	15	Aerobic	12	Aerobic capacity Proteomic analysis Molecular profile	↔ CPK	↑ Aerobic capacity ↑ Genes related to capillary growth, mitochondrial biogenesis, protein synthesis, cytoskeletal remodeling and muscular hypertrophy ↑ Genes related to the immune and inflammatory response and sarcoplasmic reticulum stress

Author	Patients (n)	Disease activity	Protocol (Exercises)	Time (week)	Evaluated components	Inflammatory markers	Results
Escalante et al. [⁹]	5	Active	Strength Dynamic	8	Isometric strength	↔ CPK	↑ Isometric strength
Alexanderson et al. [²⁴]	11	Active	Strength Dynamic	12	Muscle function Quality of life	↔ CPK	↑ Muscle function ↑ Quality of life
aVarvu et al. [⁴⁵]	19	Chronic/Active	Strength Dynamic	3	Respiratory function (Spirometry) Muscle strength	↔ CPK	↑ Respiratory function ↑ Muscle function
Mattar et al. [²⁹]	3	Active	Strength Aerobic	12	Muscle strength Functional capacity Quality of life	↔ CPK↔ Aldolase	↑ Muscle strength ↑ Functional capacity ↑ Quality of life

Author	Patients (n)	Protocol (Exercises)	Time (week)	Evaluated Components	Inflammatory markers	Results
Spector et al. [³⁵]	5	Strength Dynamic	12	Isometric strength 3 MVC	↔ CPK ↔ Immune / inflammatory markers	↑ Isometric strength ↑ 3 MVC ↔ Increased cross-sectional area
Arnardottir et al. [³⁹]	7	Strength Dynamic	12	Isometric strength	↔ CPK ↔ Cytokines ↔ Adhesion molecules	↑ Isometric strength
Johnson et al. [³²]	7	Aerobic	12	VO₂ peak Functional Capacity	↔ CPK	↑ VO₂ peak ↔ Functional capacity
	7	Strength Dynamic	16	Muscle strength Functional capacity	↔ CPK	↑ Muscle strength ↑ Functional capacity
Gualano et al. [³⁶]	1	Strength Dynamic With vascular occlusion	12	Muscle strength Balance Quality of life Cross-sectional area	↔ CPK	↑ Muscle strength ↑ Balance ↑ Quality of life ↑ Cross-sectional area
Santos et al. [³⁷]	1	Strength Dynamic With vascular occlusion	12	Myostatin gene Myostatin inhibitor genes	↔ CPK	↓ Myostatin gene ↑ Myostatin inhibitor genes
Jorgensen et al. [³⁸]	1	Strength Dynamic With vascular occlusion	12	Isometric strength Functional capacity Gait speed	↔ CPK	↑ Isometric strength ↑ Functional capacity ↑ Gait speed

[TFN1] 1RM 1-repetition maximum test, MVC maximum voluntary contraction test