Supervisors info:
Γεώργιος Λυρίτης, Ομότιμος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ισμήνη-Νίκη Δοντά, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Ιωάννης Τριανταφυλλόπουλος, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Summary:
Dermatomyositis is classified as an Idiopathic Inflammatory Myopathy. Its etiology is yet unknown and its incidence rare, showing a single digit prevalence per million, even in countries where incidence is noted to be higher. Various environmental factors are being considered as possible risk factors causing or triggering the disease, but scientific research on gene- environment interaction has not provided us with solid data on the matter.
Dermatomyositis’ main clinical manifestations are its characteristic skin lesions, combined with muscle abnormalities, lesions of the joints, lungs, and at a lesser extent pathological findings of the heart, and calcinosis. The latter is described as a characteristic for juvenile dermatomyositis, which is going to be treated as a separate clinical entity in each chapter of this review.
The thesis presents is going to attempt a brief clinical description of the disease, citing possible causes that may trigger it and its pathogenetic paths, as well as its classification. The purpose of the thesis is outlined in chapters six through eight, in which the role of physical therapy in treatment and rehabilitation of dermatomyositis patients is going to be thoroughly analyzed, emphasizing on the way physical therapy best practices have been shaped through clinical data. Any intervention attempted in the case of autoimmune diseases must take into account all possible outcomes and take advantage of the most recent research findings. Understanding the symptoms is a safe pathway for the design of any intervention, which is why this thesis outlines all possible symptoms of the disease.
The choice of the research data reviewed here was made based on the number of citations made by other papers, the date of publication, but mainly based upon the design of the trial in order to reach to conclusions. Thus, papers with a relatively larger and randomized sample with control groups were preferred. Dermatomyositis is a rare condition and up until recently therapeutic approaches focused on dealing with the inflammation and bed rest was suggested until symptoms’ recession. This practice led to low muscle functionality, caused not only by the disease itself, its synergy with prolonged bed – resting period and the adverse effects of drugs administered to manage inflammation (glucocorticoids).
Recent studies found that many chronic patients never managed to reach muscle strength and full functional mobility they had before the disease’s outbreak/ diagnosis. Physical therapy can design and implement therapeutic exercise regimes, not only in the chronic stage of the disease, but most importantly contribute in the patients’ treatment and rehabilitation with intervention regimes, as early as the first week of diagnosis.
Keywords:
Dermatomyositis, Physical therapy, Aerobic exercise, Functionality, Quality of life
