Invited Review: Update on Exercise in Persons With Muscle Disease
Abstract
Myopathies are heterogeneous in their etiology, muscle group involvement, clinical manifestation, and progression. Deficits in myopathy may include muscle weakness, atrophy, stiffness, myalgia, and extra-muscular manifestations. Consequently, these deficits could lead to impaired musculoskeletal function, inadequate engagement in daily activities and reduced participation in social activities. Exercise has been viewed as a potentially efficacious intervention to halt the loss of muscle function and to improve secondary symptoms that result from muscle loss, such as pain and fatigue. The purpose of this review is to discuss research findings within the last 10 years that examine effects of exercise interventions in many types of myopathies in humans. In general, most studies were small scale, and they varied with respect to exercise type, intensity, and outcome measures. Despite the different pathologies, various exercise subtypes of aerobic/endurance or strength/resistance training are generally beneficial and may improve muscle strength and functional outcomes. Exercise therapies are generally safe and well tolerated. Exercise prescription should be part of routine neuromuscular care for patients with myopathy, and ideally with input from a multidisciplinary team, with a focus on providing individualized exercise regimens. Further work is needed to define the optimal intensity and type of exercise to result in the best functional outcomes for persons with myopathy, as well as the effects of combining exercise and novel disease modifying therapies.
Objectives:The objectives of this activity are to (1) understand the differences between aerobic, resistance, and balance exercises, and be able to address the challenges of implementing them in individuals with muscle disease; (2) develop a basic understanding of fundamental exercise studies in patients with muscular dystrophies, myotonic disorders, and congenital, mitochondrial, metabolic, and inflammatory myopathies; (3) be able to develop an exercised-based care plan and customized exercise prescription for patients with various muscle diseases.
This paper underwent review by the Muscle & Nerve editor, but did not undergo additional, external peer review.
ACCREDITATION STATEMENT The AANEM is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
CREDIT DESIGNATION The AANEM designates this enduring material for a maximum of 1
AMA PRA Category 1 Credits TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
DISCLOSURES
Dr. Zach Simmons (editor) has no conflicts of interest. Relevant financial relationships of the article’s authors have been disclosed and managed through the journal’s editorial review process.
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Mansoureh Mamarabadi; Virginia Kudritzki; Yuebing Li; | Ileana M. Howard