Efetividade do treinamento físico sobre o desempenho físico em pacientes com dermatomiosite e polimiosite
revisão sistemática e metanálise
DOI:
https://doi.org/10.1590/1809-2950/21001328032021Resumo
| Este estudo teve por objetivo avaliar o impacto
do treinamento físico sobre o desempenho físico em
pacientes com dermatomiosite e polimiosite. Para tanto,
uma revisão sistemática e metanálise foi conduzida de
acordo com as diretrizes do PRISMA (Preferred Reporting
Items for Systematic Reviews and Meta-Analyses). A
pesquisa bibliográfica foi realizada nas seguintes bases
de dados: PubMed/MEDLINE e Web of Science, utilizando
combinações das seguintes palavras-chave em inglês:
dermatomyositis OR polymyositis OR myositis AND
exercise OR physical exercise OR physical therapy OR
aerobic exercise OR endurance exercise OR resistance
exercise. Foram incluídos estudos que atenderam aos
seguintes critérios: (1) os participantes apresentavam
diagnóstico de dermatomiosite ou polimiosite; (2)
os pacientes foram submetidos a um protocolo de
treinamento físico; (3) o desempenho físico foi mensurado
antes e após o protocolo de treinamento físico. Um
total de 14 artigos foram selecionados para inclusão na
revisão sistemática e 10 artigos foram selecionados para
inclusão na metanálise. Os resultados demonstram que o
treinamento físico é eficaz em aumentar o desempenho
físico global nos pacientes com dermatomiosite e
polimiosite (tamanho do efeito: 0,72; IC 95% 0,55; 0,89).
Além disso, foi demonstrado também que tanto as
variáveis de desempenho aeróbio (tamanho do efeito:
0,88; IC 95% 0,54; 1,21), quanto as variáveis de desempenho
resistido (tamanho do efeito: 0,64; IC 95% 0,43; 0,85) são
beneficiadas com o treinamento físico nesses pacientes.
Conclui-se que o treinamento físico apresentou um efeito
benéfico significativo sobre o desempenho físico global,
aeróbio e resistido em pacientes com dermatomiosite e
polimiosite
Downloads
Referências
Alexanderson H. Exercise in Myositis. Curr Treatm Opt
Rheumatol. 2018;4(4):289-98. doi: 10.1007/s40674-018-0113-3.
Pipitone N, Salvarani C. Treatment of inflammatory
myopathies. Expert Rev Clin Immunol. 2018;14(7):607-21. doi:
1080/1744666X.2018.1491307.
Findlay AR, Goyal NA, Mozaffar T. An overview of polymyositis
and dermatomyositis. Muscle Nerve. 2015;51(5):638-56. doi:
1002/mus.24566.
Ortigosa LCM, Reis VMS. Dermatomiosite. Anais
Brasileiros de Dermatologia. 2008;83:247-59. doi: 10.1590/
S0365-05962008000300010.
Bohan A, Peter JB. Polymyositis and dermatomyositis (first
of two parts). N Engl J Med. 1975;292(7):344-7. doi: 10.1056/
NEJM197502132920706.
Bohan A, Peter JB. Polymyositis and dermatomyositis (second
of two parts). N Engl J Med. 1975;292(8):403-7. doi: 10.1056/
NEJM197502202920807.
Drake LA, Dinehart SM, Farmer ER, Goltz RW, Graham GF,
Hordinsky MK, et al. Guidelines of care for dermatomyositis.
American Academy of Dermatology. J Am Acad Dermatol
[Internet]. 1996 [cited 2021 Sep 29];34(5 Pt 1):824-9. Available
from: https://bit.ly/3zMRA3N
Diaz MTM, Fraga PS, Silva MG, Shinjo SK. Muscle biopsies
in dermatomyositis and polymyositis: practical relevance of
analyzing different levels of histological sections of the same
muscular compartment. J Bras Patol Med Lab. 2017;53:196-201.
doi: 10.5935/1676-2444.20170031.
Cobos GA, Femia A, Vleugels RA. Dermatomyositis: an
update on diagnosis and treatment. Am J Clin Dermatol.
;21(3):339-353. doi: 10.1007/s40257-020-00502-6.
Sasaki H, Kohsaka H. Current diagnosis and treatment
of polymyositis and dermatomyositis. Mod Rheumatol.
;28(6):913-21. doi: 10.1080/14397595.2018.1467257.
Sousa DPN, Lombardi I Jr. Avaliação da capacidade aeróbia
e exercícios resistidos em pacientes com dermatomiosite e
polimiosite juvenil: revisão de literatura. Fisioter Mov [Internet].
[cited 2021 Sep 29];22(4):489-96. Available from: https://
bit.ly/3odTI2D
Painelli VS, Gualano B, Artioli GG, Sa Pinto AL, Bonfa E, Lancha
AH Jr, et al. The possible role of physical exercise on the
treatment of idiopathic inflammatory myopathies. Autoimmun
Rev. 2009;8(5):355-9. doi: 10.1016/j.autrev.2008.11.008.
Alexanderson H. Exercise effects in patients with adult
idiopathic inflammatory myopathies. Curr Opin Rheumatol.
;21(2):158-63. doi: 10.1097/BOR.0b013e328324e700.
Alexanderson H. Exercise in inflammatory myopathies, including
inclusion body myositis. Curr Rheumatol Rep. 2012;14(3):244-51.
doi: 10.1007/s11926-012-0248-4.
Alexanderson H, Lundberg IE. Exercise as a therapeutic
modality in patients with idiopathic inflammatory myopathies.
Curr Opin Rheumatol. 2012;24(2):201-7. doi: 10.1097/
BOR.0b013e32834f19f5.
Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA
Group. Preferred reporting items for systematic reviews
and meta-analyses: the PRISMA statement. PLoS Med.
;6(7):e1000097. doi: 10.1371/journal.pmed.1000097.
Higgins JPT, Green S, editors. Cochrane handbook for
systematic reviews of interventions [Internet]. [cited 2021
Sep 29]. London: The Cochrane Collaboration; 2011. Available
from: https://bit.ly/3zT5oKa
Cohen J. Statistical power analysis for the behavioral sciences.
nd ed. Hillsdale: Lawrence Earlbaum Associates; 1988.
Alemo-Munters L, Dastmalchi M, Katz A, Esbjornsson M, Loell I,
Hanna B, et al. Improved exercise performance and increased
aerobic capacity after endurance training of patients with
stable polymyositis and dermatomyositis. Arthritis Res Ther.
;15(4):R83. doi: 10.1186/ar4263.
Alemo-Munters L, Dastmalchi M, Andgren V, Emilson C,
Bergegard J, Regardt M, et al. Improvement in health and
possible reduction in disease activity using endurance exercise
in patients with established polymyositis and dermatomyositis:
a multicenter randomized controlled trial with a 1-year
open extension followup. Arthritis Care Res (Hoboken).
;65(12):1959-68. doi: 10.1002/acr.22068.
Alemo-Munters LA, Loell I, Ossipova E, Raouf J, Dastmalchi
M, Lindroos E, et al. Endurance exercise improves molecular
pathways of aerobic metabolism in patients with myositis.
Arthritis Rheumatol. 2016;68(7):1738-50. doi: 10.1002/art.39624.
Alexanderson H, Stenstrom CH, Lundberg I. Safety of a
home exercise programme in patients with polymyositis
and dermatomyositis: a pilot study. Rheumatology (Oxford).
;38(7):608-11. doi: 10.1093/rheumatology/38.7.608.
Alexanderson H, Dastmalchi M, Esbjornsson-Liljedahl M, Opava
CH, Lundberg IE. Benefits of intensive resistance training in
patients with chronic polymyositis or dermatomyositis. Arthritis
Rheum. 2007;57(5):768-77. doi: 10.1002/art.22780.
Habers GE, Bos GJ, van Royen-Kerkhof A, Lelieveld OT,
Armbrust W, Takken T, et al. Muscles in motion: a randomized
controlled trial on the feasibility, safety and efficacy of an
exercise training programme in children and adolescents
with juvenile dermatomyositis. Rheumatology (Oxford).
;55(7):1251-62. doi: 10.1093/rheumatology/kew026.
Mattar MA, Gualano B, Perandini LA, Shinjo SK, Lima FR, SaPinto AL, et al. Safety and possible effects of low-intensity
resistance training associated with partial blood flow restriction
in polymyositis and dermatomyositis. Arthritis Res Ther.
;16(5):473. doi: 10.1186/s13075-014-0473-5.
Nader GA, Dastmalchi M, Alexanderson H, Grundtman C,
Gernapudi R, Esbjornsson M, et al. A longitudinal, integrated,
clinical, histological and mRNA profiling study of resistance
exercise in myositis. Mol Med. 2010;16(11-12):455-64. doi: 10.2119/
molmed.2010.00016.
Oliveira DS, Borges IBP, Souza JM, Gualano B, Pereira RMR,
Shinjo SK. Exercise training attenuates insulin resistance
and improves beta-cell function in patients with systemic
autoimmune myopathies: a pilot study. Clin Rheumatol.
;38(12):3435-42. doi: 10.1007/s10067-019-04738-4.
Omori CH, Silva CAA, Sallum AME, Pereira RMR, Pinto ALS,
Roschel H, et al. Exercise training in juvenile dermatomyositis.
Arthritis Care Res (Hoboken). 2012;64(8):1186-94. doi: 10.1002/
acr.21684.
Riisager M, Mathiesen PR, Vissing J, Preisler N, Orngreen MC.
Aerobic training in persons who have recovered from juvenile
dermatomyositis. Neuromuscul Disord. 2013;23(12):962-8. doi:
1016/j.nmd.2013.09.002.
Varju C, Petho E, Kutas R, Czirjak L. The effect of physical
exercise following acute disease exacerbation in patients
with dermato/polymyositis. Clin Rehabil. 2003;17(1):83-7. doi:
1191/0269215503cr572oa.
Wiesinger GF, Quittan M, Graninger M, Seeber A, Ebenbichler G,
Sturm B, et al. Benefit of 6 months long-term physical training
in polymyositis/dermatomyositis patients. Br J Rheumatol.
;37(12):1338-42. doi: 10.1093/rheumatology/37.12.1338.
Wiesinger GF, Quittan M, Aringer M, Seeber A, Volc-Platzer B,
Smolen J, et al. Improvement of physical fitness and muscle
strength in polymyositis/dermatomyositis patients by a training
programme. Br J Rheumatol. 1998;37(2):196-200. doi: 10.1093/
rheumatology/37.2.196.
Souza FHC, Araujo DB, Vilela VS, Bezerra MC, Simoes RS,
Bernardo WM, et al. Guidelines of the Brazilian Society of
Rheumatology for the treatment of systemic autoimmune
myopathies. Adv Rheumatol. 2019;59(1):6. doi: 10.1186/
s42358-019-0048-x
Downloads
Publicado
Edição
Seção
Licença
Copyright (c) 2021 Teixeira VP, Costa TS, Moeira VCS, Campos HO
Este trabalho está licenciado sob uma licença Creative Commons Attribution-ShareAlike 4.0 International License.
