Helene Alexanderson1,2, Malin Regardt3,4, Christina Ottosson3,4, Li Alemo Munters3,4, Maryam Dastmalchi3,4, Lara Dani3,4, Ingrid E Lundberg3,4. 1. From the Department of Care Science and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge; Functional Area Occupational Therapy and Physiotherapy, Allied Health Professionals Function, and the Rheumatology Clinic, Karolinska University Hospital, Stockholm; Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm; Rheumatology Unit, Department of Medicine, Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. helene.alexanderson@sll.se. 2. H. Alexanderson, PhD, RPT, Department of Care Science and Society, Division of Physiotherapy, Karolinska Institutet, and Functional Area Occupational Therapy and Physiotherapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, ROT, Functional Area Occupational Therapy and Physiotherapy, Allied Health Professionals Function, Karolinska University Hospital, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet; C. Ottosson, RN, Rheumatology Clinic, Karolinska University Hospital; L. Alemo Munters, PhD, RPT, Functional Area Occupational Therapy and Physiotherapy, Allied Health Professionals Function, Karolinska University Hospital; M. Dastmalchi, PhD, MD, Rheumatology Clinic, Karolinska University Hospital, and Rheumatology Unit, Department of Medicine, Solna, Karolinska Institutet, Karolinska University Hospital; L. Dani, MD, Rheumatology Clinic, Karolinska University Hospital, and Rheumatology Unit, Department of Medicine, Solna, Karolinska Institutet, Karolinska University Hospital; I.E. Lundberg, PhD, MD, Rheumatology Clinic, Karolinska University Hospital, and Rheumatology Unit, Department of Medicine, Solna, Karolinska Institutet, Karolinska University Hospital. helene.alexanderson@sll.se. 3. From the Department of Care Science and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge; Functional Area Occupational Therapy and Physiotherapy, Allied Health Professionals Function, and the Rheumatology Clinic, Karolinska University Hospital, Stockholm; Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm; Rheumatology Unit, Department of Medicine, Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. 4. H. Alexanderson, PhD, RPT, Department of Care Science and Society, Division of Physiotherapy, Karolinska Institutet, and Functional Area Occupational Therapy and Physiotherapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, ROT, Functional Area Occupational Therapy and Physiotherapy, Allied Health Professionals Function, Karolinska University Hospital, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet; C. Ottosson, RN, Rheumatology Clinic, Karolinska University Hospital; L. Alemo Munters, PhD, RPT, Functional Area Occupational Therapy and Physiotherapy, Allied Health Professionals Function, Karolinska University Hospital; M. Dastmalchi, PhD, MD, Rheumatology Clinic, Karolinska University Hospital, and Rheumatology Unit, Department of Medicine, Solna, Karolinska Institutet, Karolinska University Hospital; L. Dani, MD, Rheumatology Clinic, Karolinska University Hospital, and Rheumatology Unit, Department of Medicine, Solna, Karolinska Institutet, Karolinska University Hospital; I.E. Lundberg, PhD, MD, Rheumatology Clinic, Karolinska University Hospital, and Rheumatology Unit, Department of Medicine, Solna, Karolinska Institutet, Karolinska University Hospital.
Abstract
OBJECTIVE: To investigate muscle impairment (isometric and dynamic) and disease activity during the first year after diagnosis of polymyositis (PM) and dermatomyositis (DM), and to study the relationship between muscle impairment, patient-reported health, and disease activity. METHODS: Seventy-two patients enrolled in the Swedish Myositis Register, 2003-2010, were followed prospectively. The Manual Muscle test (MMT-8; isometric muscle strength), the Functional Index of myositis test (FI-2; dynamic, repetitive muscle function), and disease activity (6-item core set) were retrieved at the time of diagnosis, and after 6 and 12 months. Self-reported health (Medical Outcomes Study Short Form-36; SF-36) was retrieved at 12 months. RESULTS: At the time of diagnosis, median (Q1-Q3) for the FI-2 was 27.2% (7.9-60.5%) of maximal score compared to 93.8% (92.5-98.8%) of maximal MMT-8. At 12 months, the FI-2 and the MMT-8 improved to 29.4% (16.5-60.7%; p < 0.05) and 96.1% (88.1-99.4%), respectively (p < 0.01). At 12 months, 45% of patients improved ≥ 20%, and 27% worsened ≥ 20% in FI-2 score, while 10% improved ≥ 20% in MMT-8. Physician's global visual analog scale (VAS), Health Assessment Questionnaire, and creatine phosphokinase levels improved significantly at 12 months (p < 0.05-0.001) while patient's global and extramuscular VAS remained unchanged. The SF-36 physical function correlated strongly with the FI-2 (rs = 0.74; CI 0.55-0.85) and moderately with the MMT (rs = 0.54; CI 0.27-0.73), with lower correlations between muscle function and other SF-36 domains. CONCLUSION: Patients with PM/DM were characterized by impaired dynamic repetitive muscle function (DRMF) that correlated well with patient-reported physical function. Assessment of DRMF adds information regarding muscle impairment in these patients.
OBJECTIVE: To investigate muscle impairment (isometric and dynamic) and disease activity during the first year after diagnosis of polymyositis (PM) and dermatomyositis (DM), and to study the relationship between muscle impairment, patient-reported health, and disease activity. METHODS: Seventy-two patients enrolled in the Swedish Myositis Register, 2003-2010, were followed prospectively. The Manual Muscle test (MMT-8; isometric muscle strength), the Functional Index of myositis test (FI-2; dynamic, repetitive muscle function), and disease activity (6-item core set) were retrieved at the time of diagnosis, and after 6 and 12 months. Self-reported health (Medical Outcomes Study Short Form-36; SF-36) was retrieved at 12 months. RESULTS: At the time of diagnosis, median (Q1-Q3) for the FI-2 was 27.2% (7.9-60.5%) of maximal score compared to 93.8% (92.5-98.8%) of maximal MMT-8. At 12 months, the FI-2 and the MMT-8 improved to 29.4% (16.5-60.7%; p < 0.05) and 96.1% (88.1-99.4%), respectively (p < 0.01). At 12 months, 45% of patients improved ≥ 20%, and 27% worsened ≥ 20% in FI-2 score, while 10% improved ≥ 20% in MMT-8. Physician's global visual analog scale (VAS), Health Assessment Questionnaire, and creatine phosphokinase levels improved significantly at 12 months (p < 0.05-0.001) while patient's global and extramuscular VAS remained unchanged. The SF-36 physical function correlated strongly with the FI-2 (rs = 0.74; CI 0.55-0.85) and moderately with the MMT (rs = 0.54; CI 0.27-0.73), with lower correlations between muscle function and other SF-36 domains. CONCLUSION:Patients with PM/DM were characterized by impaired dynamic repetitive muscle function (DRMF) that correlated well with patient-reported physical function. Assessment of DRMF adds information regarding muscle impairment in these patients.
Authors: David R Amici; Iago Pinal-Fernandez; Ruben Pagkatipunan; Albert Mears; Rebecca de Lorenzo; Eleni Tiniakou; Jemima Albayda; Julie J Paik; Thomas E Lloyd; Lisa Christopher-Stine; Andrew L Mammen; Tae Chung Journal: Muscle Nerve Date: 2018-12-18 Impact factor: 3.217
Authors: Henrik Pettersson; Helene Alexanderson; Janet L Poole; Janos Varga; Malin Regardt; Anne-Marie Russell; Yasser Salam; Kelly Jensen; Jennifer Mansour; Tracy Frech; Carol Feghali-Bostwick; Cecília Varjú; Nancy Baldwin; Matty Heenan; Kim Fligelstone; Monica Holmner; Matthew R Lammi; Mary Beth Scholand; Lee Shapiro; Elizabeth R Volkmann; Lesley Ann Saketkoo Journal: Best Pract Res Clin Rheumatol Date: 2021-07-01 Impact factor: 4.991
Authors: Floranne C Ernste; Christopher Chong; Cynthia S Crowson; Tanaz A Kermani; Orla Ni Mhuircheartaigh; Helene Alexanderson Journal: J Rheumatol Date: 2020-04-15 Impact factor: 4.666