Fysioterapeuten nr. 6 - 2016

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FYSIOTERAPEUTEN 6/16 23
sykdomsaktivitet og store sykdomskonse-
kvenser. Derfor er det viktig å bruke klinisk
skjønn og tilpasse treningsopplegg og dose-
ring etter hver enkelt pasients mål, funksjon
og sykdomstilstand.
Takk
Artikkelen er støttet av Fond til etter- og vi-
dereutdanning av fysioterapeuter.
Vi takker professor/fysioterapeut Anne
Marit Mengshoel og professor dr. med. Øy-
vind Molberg for gode innspill og veiled-
ning.
Referanser
1. Palm Ø. [updated 2015].
Available from:
2. Hochberg MC, Silman AJ, Smolen JS, Weinblatt
ME, Weisman MH. Rheumatology. Fourth ed: Mosby
Elsevier; 2008.
3. Barnes JN, Tanaka H. Cardiovascular benefits of
habitual exercise in systemic lupus erythematosus:
a review. The Physician and sportsmedicine. 2012
Sep;40(3):43-8. PubMed PMID: 23528620.
4. Chugh PK. Management of women with systemic
lupus erythematosus. Maturitas. 2013 Jul;75(3):207-
14. PubMed PMID: 23632038. Epub 2013/05/02. eng.
5. Lerang K, Gilboe I-M, Steinar Thelle D, Gran JT.
Mortality and years of potential life loss in systemic
lupus erythematosus: a population-based cohort study.
Lupus. 2014 December 1, 2014;23(14):1546-52.
6. Tench C, Bentley D, Vleck V, McCurdie I, White P,
D’Cruz D. Aerobic fitness, fatigue, and physical disa-
bility in systemic lupus erythematosus. J Rheumatol.
2002 Mar;29(3):474-81. PubMed PMID: 11908559.
7. Nasjonal kompetansetjeneste for revmatisk rehabili-
tering, Diakonhjemmet sykehus. Available from: http://
-
personell/nasjonal-kompetansetjeneste-for-revmatolo-
gisk-rehabilitering?D=2&C=589&I=1817.
8. ATS Board of Directors. ATS Statement. Am J Respir
Crit Care Med. 2002 2002/07/01;166(1):111-7.
9. Ayan C, Martin V. Systemic lupus erythematosus
and exercise. Lupus. 2007;16(1):5-9. PubMed PMID:
17283578. Epub 2007/02/08. eng.
10. Strombeck B, Jacobsson LT. The role of exercise
in the rehabilitation of patients with systemic lupus
erythematosus and patients with primary Sjogren’s syn-
drome. Curr Opin Rheumatol. 2007 Mar;19(2):197-203.
PubMed PMID: 17278938. Epub 2007/02/07. eng.
11. Benatti FB, Pedersen BK. Exercise as an anti-
inflammatory therapy for rheumatic diseases-myokine
regulation. Nature reviews Rheumatology. 2015
Feb;11(2):86-97. PubMed PMID: 25422002. Epub
2014/11/26. Eng.
12. Eriksson K, Svenungsson E, Karreskog H, Gunnars-
son I, Gustafsson J, Moller S, et al. Physical activity in
patients with systemic lupus erythematosus and mat-
ched controls. Scand J Rheumatol. 2012 Aug;41(4):290-
7. PubMed PMID: 22651371.
13. Hoffmann-Vold AM, Molberg O, Midtvedt O, Garen T,
Gran JT. Survival and causes of death in an unselected
and complete cohort of Norwegian patients with sys-
temic sclerosis. J Rheumatol. 2013 Jul;40(7):1127-33.
PubMed PMID: 23637316. Epub 2013/05/03. eng.
14. Poole JL, Macintyre NJ, Deboer HN. Evidence-based
management of hand and mouth disability in a woman
living with diffuse systemic sclerosis (scleroderma).
Physiother Can. 2013 Fall;65(4):317-20. PubMed
PMID: 24396157. Pubmed Central PMCID: 3817882.
15. Maddali-Bongi S, Del Rosso A, Mikhaylova S, Fran-
cini B, Branchi A, Baccini M, et al. Impact of hand and
mouth disabilities on global disability and quality of
life in systemic sclerosis patients. Clin Exp Rheumatol.
2014;32(suppl. 86):S15-S20.
16. Poole JL. Musculoskeletal rehabilitation in the
person with scleroderma. Curr Opin Rheumatol. 2010
Mar;22(2):205-12. PubMed PMID: 20019617. Epub
2009/12/19. eng.
17. Malcarne VL, Fox RS, Mills SD, Gholizadeh S.
Psychosocial aspects of systemic sclerosis. Curr Opin
Rheumatol. 2013 Nov;25(6):707-13. PubMed PMID:
24067378. Epub 2013/09/27. eng.
18. Sandqvist G, Nilsson J-Å, Wuttge DM, Hesselstrand
R. Development of a Modified Hand Mobility in Sclero-
derma (HAMIS) Test and its Potential as an Outcome
Measure in Systemic Sclerosis. The Journal of Rheuma-
tology. 2014 November 1, 2014;41(11):2186-92.
19. Willems LM, Vriezekolk JE, Schouffoer AA, Poole JL,
Stamm TA, Boström C, et al. Effectiveness of Nonphar-
macologic Interventions in Systemic Sclerosis: A Syste-
matic Review. Arthritis Care Res. 2015;67(10):1426-
39.
20. Alexanderson H, Bergegard J, Bjornadal L, Nordin
A. Intensive aerobic and muscle endurance exercise
in patients with systemic sclerosis: a pilot study. BMC
Res Notes. 2014;7(1):86. PubMed PMID: 24507585.
Pubmed Central PMCID: 3996139.
21. Spruit MA, Singh SJ, Garvey C, ZuWallack R, Nici
L, Rochester C, et al. An official American Thoracic
Society/European Respiratory Society statement: key
concepts and advances in pulmonary rehabilitation. Am
J Respir Crit Care Med. 2013 Oct 15;188(8):e13-64.
PubMed PMID: 24127811. Epub 2013/10/17. eng.
22. Andersson H. Idiopatiske inflammatoriske myopa-
tier. Norsk Epidemiologi. 2008;18(1):73-7.
23. Dobloug C, Garen T, Bitter H, Stjärne J, Stenseth G,
Grøvle L, et al. Prevalence and clinical characteristics
of adult polymyositis and dermatomyositis; data from
a large and unselected Norwegian cohort. Ann Rheum
Dis. 2015 August 1, 2015;74(8):1551-6.
24. Alemo Munters L, Alexanderson H, Crofford LJ,
Lundberg IE. New insights into the benefits of exercise
for muscle health in patients with idiopathic inflam-
matory myositis. Current rheumatology reports. 2014
Jul;16(7):429. PubMed PMID: 24879535. Pubmed
Central PMCID: PMC4133148. Epub 2014/06/01. eng.
25. Lundberg IE, Vencovsky J, Alexanderson H.
Therapy of myositis: biological and physical. Curr Opin
Rheumatol. 2014 Nov;26(6):704-11. PubMed PMID:
25198241.
26. Kendall FP, McCreary EK, Provance PG. Muscles tes-
ting and function: Lippincott Williams & Wilkins; 1993.
27. Rider LG. Outcome assessment in the adult and
juvenile idiopathic inflammatory myopathies. Rheum
Dis Clin North Am. 2002;28:935-77.
28. Habers GE, Takken T. Safety and efficacy of
exercise training in patients with an idiopathic inflam-
matory myopathy--a systematic review. Rheumatology
(Oxford). 2011 Nov;50(11):2113-24. PubMed PMID:
21890619. Epub 2011/09/06. eng.
29. Christie A, Olsen AL, Birkeland B-E, Flaatten H,
Enger KJ, Skattør M, et al. Trening ved polymyositt og
dermatomyositt: 2012. Fagprose-
dyre]. Available from:
microsite/Fagprosedyrer.
Physical function and exercise in patients with connective tissue diseases.
Abstract
n Introduction: Inflammatory connective tissues diseases – systemic lupus erythemato-
sus, systemic sclerosis and myositis can cause severe impairments and disability.
n Main part: Adjusted physical exercise and physiotherapy can improve physical function
and reduce and prevent other negative consequences of these diseases, for example
fatigue. Exercise programs well adapted for the patients’ condition have not been found
to aggravate the disease activity and may even reduce inflammation.
n Conclusion : Exercise and physiotherapy are recommended therapies in these diseases.
Designing individual exercise program for the patient can be challenging because of the
complexity of the disease and fluctuations in symptoms, especially with patients with
severe disease. More research in this field is therefore highly recommended.
n Keywords: Connective tissue diseases, physical function, exercise.
Hovedbudskap
De fleste pasienter med bindevevssykdom-
mer kan være fysisk aktive og trene så
lenge aktiviteten tilpasses den enkelte
pasients funksjon og sykdomsaktivitet.