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Postrehabilitation Functional Improvements in Patients With Inflammatory Myopathies: The Results of a Randomized Controlled Trial

Published:October 24, 2016DOI:https://doi.org/10.1016/j.apmr.2016.09.125

      Abstract

      Objective

      To evaluate the medium-term functional effect and the effect on quality of life of a standardized rehabilitation program in patients with inflammatory myopathies (IMs).

      Design

      A multicenter, randomized controlled trial.

      Setting

      Four university hospitals.

      Participants

      Patients (N=21) with polymyositis.

      Interventions

      The intervention group participated in a 4-week standardized, hospital-based rehabilitation program followed by a personalized, self-managed, home-based rehabilitation program. The control group received physiotherapy on an outpatient basis. Study participants were evaluated at inclusion, at the end of the rehabilitation program (1mo), and then at 6 and 12 months.

      Main Outcome Measures

      The primary efficacy criterion was the Health Assessment Questionnaire Disability Index (HAQ-DI), and the secondary criteria were quality of life (according to the Medical Outcomes Study 36-Item Short-Form Health Survey [SF-36] questionnaire), muscle performance (isokinetic strength, Motor Function Measure, and Kendall Manual Muscle Test), gait, pain, fatigue, and biomarkers of tolerance and disease activity.

      Results

      At 12 months, the mean ± SD HAQ-DI was significantly lower in the intervention group than in the control group (.64±.53 vs 1.36±1.02; P=.026). The intervention group also had better scores than the control group for some quality-of-life dimensions (SF-36 General Health: 53.44±8.73 vs 36.57±22.10, respectively; P=.038; SF-36 Role Physical: 63.89±43.50 vs 17.86±37.40, respectively; P=.023) and pain levels (5.0±10.61 vs 33.38±35.68, respectively; P=.04) at 12 months. The program was well tolerated by all the participants.

      Conclusions

      In patients with IMs, the combination of a 4-week standardized rehabilitation program and a personalized, home-based, self-managed rehabilitation program was well tolerated and had a positive medium-term functional effect.

      Keywords

      List of abbreviations:

      CPK (creatine phosphokinase), DM (dermatomyositis), HAQ-DI (Health Assessment Questionnaire Disability Index), IM (inflammatory myopathy), MMT (Manual Muscle Test), PM (polymyositis), SF-36 (Medical Outcomes Study 36-Item Short-Form Health Survey)
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