Safety and efficacy of strength training in patients with sporadic inclusion body myositis

We studied the effects of a 12‐week progressive resistance strength training program in weakened muscles of 5 patients with sporadic inclusion body myositis (IBM). Strength was evaluated with Medical Research Council (MRC) scale ratings and quantitative isometric and dynamic tests. Changes in serum creatine kinase (CK), lymphocyte subpopulations, muscle size (determined by magnetic resonance imaging), and histology in repeated muscle biopsies were examined before and after training. After 12 weeks, the values of repetition maximum improved in the least weakened muscles, 25–120% from baseline. This dynamic effect was not captured by MRC or isometric muscle strength measurements. Serum CK, B cells, T‐cell subsets, and NK cells remained unchanged. Repeat muscle biopsies did not reveal changes in the number and degree of degenerating fibers or inflammation. The size of the trained muscles did not change. We conclude that a supervised progressive resistance training program in IBM patients can lead to gains in dynamic strength of the least weak muscles without causing muscle fatigue and muscle injury or serological, histological, and immunological abnormalities. Even though the functional significance of these gains is unclear, this treatment modality is a safe and perhaps overlooked means of rehabilitation of IBM patients. © 1997 John Wiley & Sons, Inc. Muscle Nerve 20: 1242–1248, 1997

[1]  A. Engel,et al.  Monoclonal antibody analysis of mononuclear cells in myopathies. V: Identification and quantitation of T8+ cytotoxic and T8+ suppressor cells , 1988, Annals of neurology.

[2]  N. Larocca,et al.  The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. , 1989, Archives of neurology.

[3]  M. Dalakas Polymyositis, dermatomyositis and inclusion-body myositis. , 1991, The New England journal of medicine.

[4]  M. Pollock,et al.  Injuries and adherence to walk/jog and resistance training programs in the elderly. , 1991, Medicine and science in sports and exercise.

[5]  D. Jones,et al.  Large delayed plasma creatine kinase changes after stepping exercise , 1983, Muscle & nerve.

[6]  M. Dalakas,et al.  Inclusion Body Myositis: New Concepts , 1993, Seminars in neurology.

[7]  H. Milner-Brown,et al.  Muscle strengthening through high-resistance weight training in patients with neuromuscular disorders. , 1988, Archives of physical medicine and rehabilitation.

[8]  D. Newham,et al.  Experimental human muscle damage: morphological changes in relation to other indices of damage. , 1986, The Journal of physiology.

[9]  L. Miller,et al.  Resistive exercise in the rehabilitation of polymyositis/dermatomyositis. , 1993, The Journal of rheumatology.

[10]  M. McCrory,et al.  Moderate resistance exercise program: its effect in slowly progressive neuromuscular disease. , 1993, Archives of physical medicine and rehabilitation.

[11]  M. Dalakas,et al.  Strength gains without muscle injury after strength training in patients with postpolio muscular atrophy , 1996, Muscle & nerve.

[12]  M. Dalakas,et al.  Current concepts in the idiopathic inflammatory myopathies: polymyositis, dermatomyositis, and related disorders. , 1989, Annals of internal medicine.

[13]  A. McComas,et al.  The effects of strength training in patients with selected neuromuscular disorders. , 1988, Medicine and science in sports and exercise.

[14]  M. Dalakas,et al.  Clinical, immunopathologic, and therapeutic considerations of inflammatory myopathies. , 1992, Clinical neuropharmacology.

[15]  W. Evans,et al.  Sarcopenia and age-related changes in body composition and functional capacity. , 1993, The Journal of nutrition.

[16]  P. Clarkson,et al.  Muscle Soreness and Serum Creatine Kinase Activity Following Isometric, Eccentric, and Concentric Exercise , 1985, International journal of sports medicine.

[17]  M. Dalakas,et al.  Polymyositis inpatients infected with human T‐cell leukemia virus type I: The role of the virus in the cause of the disease , 1994, Annals of neurology.

[18]  W J Litchy,et al.  Inclusion body myositis. Observations in 40 patients. , 1989, Brain : a journal of neurology.

[19]  Paul J. Vignos,et al.  Physical models of rehabilitation in neuromuscular disease , 1983, Muscle & nerve.

[20]  S B Roberts,et al.  Exercise training and nutritional supplementation for physical frailty in very elderly people. , 1994, The New England journal of medicine.

[21]  A. Eisen,et al.  Inclusion body myositis , 1978, Neurology.

[22]  R. Gougeon,et al.  Circulating mononuclear cell numbers and function during intense exercise and recovery. , 1991, Journal of applied physiology.

[23]  P. Vock,et al.  Structural Changes in Skeletal Muscle Tissue with Heavy-Resistance Exercise* , 1986, International journal of sports medicine.

[24]  D. Nieman,et al.  The immune response to exercise. , 1994, Seminars in hematology.

[25]  J. P. Miller,et al.  Effects of strength training on muscle hypertrophy and muscle cell disruption in older men. , 1993, International journal of sports medicine.

[26]  M. Dalakas,et al.  Immunocytochemical and virological characteristics of hiv‐associated inflammatory myopathies: Similarities with seronegative polymyositis , 1991, Annals of neurology.

[27]  E. Chang,et al.  Effect of the thiol-oxidizing agent diamide on NH2Cl-induced rat colonic electrolyte secretion. , 1993, The American journal of physiology.