Efficacy of aqua-based plyometric exercises in the rehabilitation of patients with juvenile dermatomyositis: A randomized crossover pilot study

Int J Rheum Dis. 2021 Jul;24(7):930-940. doi: 10.1111/1756-185X.14152. Epub 2021 Jun 12.

Abstract

Background: Patients with juvenile dermatomyositis (JDM) experience muscle weakness, tiredness, and loss of energy, which restrict their abilities in performance of their daily living activities.

Objective: To explore the effect of aquatic-based plyometric (Aqua-PLYO) exercises on muscle strength, fatigue, and functional ability in patients with JDM.

Methods: This was a randomized, single-blind, crossover pilot study that included 16 patients with JDM (age 13.44 ± 2.85 years). They were assigned randomly to receive either the Aqua-PLYO exercises (n = 8) or the standard outpatient care (SoC ; n = 8) first. After a 1-month washout, the treatment was reversed. Lower limb muscle strength, fatigue perception, functional ability, and disease activity were evaluated before and after each treatment period.

Results: Irrespective of the treatment order, the Aqua-PLYO treatment yielded greater improvement in muscle strength (hip flexors and abductors [P < 0.001] or knee flexors [P < 0.001] and extensors [P = 0.0008]), fatigue perception (P < 0.001), functional ability (P = 0.009), and disease activity (P = 0.0001) than the SoC treatment. By using the shortest confidence intervals (100[1-2α]%) of the difference, the average bioequivalence of the Aqua-PLYO and SoC has not been established at P = 0.05, because the upper and lower confidence bounds of all outcomes were not between the acceptance limits. No period or carryover effects were detected in all outcomes.

Conclusion: The Aqua-PLYO exercise protocol as implemented in this study is safe, feasible, and well-tolerated in patients with JDM and seemingly useful to help increase muscle strength, reduce fatigue, and enhance functional ability in such a patient population.

Keywords: fatigue perception; functional capacity; inflammatory myopathy; strength training; underwater exercises.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Child
  • Cross-Over Studies
  • Dermatomyositis / epidemiology
  • Dermatomyositis / physiopathology
  • Dermatomyositis / rehabilitation*
  • Exercise Therapy / methods*
  • Female
  • Humans
  • Male
  • Muscle Strength / physiology
  • Muscle Weakness
  • Pilot Projects
  • Plyometric Exercise*
  • Resistance Training / instrumentation*
  • Resistance Training / methods
  • Saudi Arabia / epidemiology
  • Single-Blind Method
  • Treatment Outcome