The secondary balance impairment that results from muscle weakness poses an additional barrier to aerobic fitness. Physical therapists should review aerobic training alternatives with their patients such as the recumbent stationary bicycle and upper-extremity ergometry. The initial session of upper-extremity ergometry should be closely monitored since it is about 25% less efficient than lower-extremity ergometry and has higher oxygen demands. Understanding the methods to monitor aerobic intensity and using creative approaches to exercise safely will allow the patient and physical therapist to craft an effective training program. By using serial strength assessments to monitor chronic disease, determining the appropriate progressive resistance exercise intensity, and being aware of the impairments of myositis that extend beyond weakness, physical therapists can play a valuable role in the clinical management of inflammatory muscle disease.
Dr. Harris-Love is assistant professor of physical therapy at the George Washington University School of Medicine and Health Sciences in Washington, DC and a visiting researcher in the Environmental Autoimmunity Group at the National Institute of Environmental Health Sciences in Bethesda, Md.
References
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- Miller FW, Rider LG, Chung YL, et al. Proposed preliminary core set measures for disease outcome assessment in adult and juvenile idiopathic inflammatory myopathies. Rheumatology. 2001;40(11):1262-1273.
- Rider LG, Giannini EH, Harris-Love M, et al. Defining clinical improvement in adult and juvenile myositis. J Rheumatol. 2003;30(3):603-617.
- Moini B, Harris-Love MO, Pokrovnichka A, Pahlajani N, Barham B, Plotz P. Muscle weakness in myositis: where to look? Arthritis Rheum. 2005;52(9):S434-S434.
- Hicks JE, Drinkard B, Sunmers RM, Rider LG. Decreased aerobic capacity in children with juvenile dermatomyositis. Arthritis Rheum. 2002;47(2):118-123.
- Persinger R, Foster C, Gibson M, Fater DC, Porcari JP. Consistency of the talk test for exercise prescription. Med Sci Sports Exerc. 2004;36(9):1632-1636.
