Objective

To evaluate the medium-term functional impact and effect on quality of life of a standardized rehabilitation programme in patients with polymyositis and dermatomyositis.

Materials/patients and methods

Design: a multicentre, randomized, controlled trial.

– Setting: four university hospitals in France.

– Participants: 20 patients suffering from polymyositis and dermatomyositis.

– Interventions: the intervention group participated in a four-week standardized, hospital-based rehabilitation programme and then a personalized, self-managed, home-based rehabilitation programme. The control group received Physiotherapy on an outpatient basis. The study participants were evaluated at inclusion, at the end of the rehabilitation programme (1 month) and then at 6 and 12 months.

– Main outcome measure(s): the primary efficacy criterion was the health assessment questionnaire disability index (HAQ-DI), and the secondary criteria were quality of life (according to the SF36 questionnaire), muscle performance (isokinetic strength, the motor function measure, and the Kendall manual muscle test (MMT), gait, pain, fatigue and biomarkers of tolerance and disease activity.

Results

At 12 months, the mean ± standard deviation HAQ-DI was significantly lower in the intervention group than in the control group (0.64 ± 0.53 vs. 1.36 ± 1.02, respectively; P = 0.026). The intervention group also had better scores than the control group for some quality of life dimensions (SF36 General Health: 53.44 ± 8.73 vs. 36.57 ± 22.10, respectively; P = 0.038; SF36 role physical (63.89 ± 43.50 vs. 17.86 ± 37.40, respectively; P = 0.023), the Kendall MMT score (85.89 ± 16.11 vs. 65.22 ± 31.50, respectively; P < 0.05) and pain levels (5.0 ± 10.61 vs. 33.38 ± 35.68, respectively; P = 0.04) at 12 months. Lastly, the programme was well tolerated by all the participants.

Discussion/Conclusion

In patients suffering from polymyositis and dermatomyositis, the combination of a four-week standardized rehabilitation programme and a personalized, home-based, self-managed rehabilitation programme was well tolerated and had a positive medium-term functional impact.