Exercise to Reduce Inflammation, Increase Strength and Flexibility

CPK-levels do not increas over weeks or months of exercise adapted to individuals with myositis. Rather, a few studies have reported a trend towards reduced CPK-levels after 3 months of exercise in polymyositis and dermatomyositis. However, it is normal that CPK-levels increase during and right after an exercise session and then return to normal after about 24 hours. Therefore it so not recommended to have your blood drawn for CPK-analysis during this time frame.

I think that a machine like you describe would be a good idea. There are only a few studies evaluating effects of exercise in IBM. They have all reported safety of light weight lifting and even more strenious exercise over 3 and 6 months. However, the results regarding the effects of exercise on muscle strength is more uncertain. I would recommend weight lifting.

We know that exercise adapted to disease activity and strength is safe, but we are not sure about the effect on for example muscle strength in active disease. However, exercise can redcue the risk of side effects from cortcosteroids. Therefor I would recommend to always exercise, but adapt the intensity to disease activity.

I would recommend you to do strengthening exercises for your legs, foremost the quadriceps and gluteal area as well as for your upper arms. Use loads allowing about 10 repetitions.

There are no studies on creatine in IBM, however, I have 2 patients in my clinic that experience some improvement of creatine in combination with exercise. Worth a try. Be sure to test your strength before starting and then do follow-up after 3-5 months.

It is not harmful to exercise until the point of muscle soreness. We have seen that muscles do leak the enzyme CPK right after an exercise bout in myositis, but that is normal and will return to normal values after about 24 hours. This is a normal process. As long as you don’t experience muscle soreness over several days and improve your strength, I would not say it is harmful. I would recommend you to start with an easy home exercise program or in a pool.

the evidence support exercise, starting about 4 weeks after diagnosis. However, exercise should be adapted to strength, fatigue and pain levels, be introduced carefully and slowly increase loads or intensity. We have done a few studies in active myositis with hight cortiocosteroid levels, and only seen CPK-levels dropping down to normal with medical treatment and exercise. Important to follow-up strength and well-being regularly, for example every third months during the first year.

You don’t need to be in remission to start extercie. it is safe to start adapted exercise after about 4 weeks from diagnosis under PT supervision and with regular follow-up.

I would recommend to exercise the hipmuscles, both abduction, extension and flexion as well as the backside of your thighs. Also exercise arms and trunk muscles.

You are very active with exercise. I would say that as long as you feel well and experience improvements from the exercise it is all well. However, if you feel that you are getting weaker over time and more fatigued that could be a sign of a flare. But that would necessarily not be due to the exercise, but can occur anyway.

It is possible to improve strength when you have DM. Start with low loads and slowly increase. You need to exercise at least twice a week for at least 8 weeks to see some results. Then you just need to keep going.

To increase strength exercise 2-3 times a week and to improve cardio exercise 3 times a week during at least 30 minutes/session. You can combine these types of exercise in the same session.

No, just be sure to exercise 2-3 days a week.

Listen to you body when it comes to exertion. Maybe better to take shorter walk more frequently. There is a home exercise program published by Johnson LG et al describing a home exercise program that would be worth while looking into together with your PT.

We analyse CPK-levels in blood and muscle biopsies. We use a conchotome technique allowing multiple biopsies. MRI is another alternative and I believe that diagnostic ultrasound could be a way.

To improve strength, exercise 2-3 days a week on at least 40-80% of max and to improve aerobic capacity exercise at least 3 days a week on 50-70% of max heart rate. You can combine these exercise types in the same session. You do not need to exercise every day. Good to rest in-between.

I would say that this gives you physical activity enough to preserve good health. If you want to increase strength in less affected muscle groups you need to do more strength exercise.

Sorry, don’t know what p90x is.

Try exercise in a heated pool.

No, do any poses that you feel comfortable with.

I think you can imporve endurance although you have active inflammation, but it is necessary to have a working medical treatment as well to improve in the long run.

It is always possible to improve, but very few regain their strength completely.

In our study we used 8 grams as a loading dose for five days and then go down to 3 grams. Hold that for 3 months and then take 4 weeks break. Be sure to exercise at the same time and follow muscle strength before and after.

Start with low loads and increase slowly. Focus on shoulder, hip and thigh muscles 2-3 days a week for at least 8 weeks. Be sure not to do all arm exercises in a row, but do legs and neck in between.