Session Information
Session Title: AA 2021 Virtual Posters - General Rehabilitation
Session Time: None. Available on demand.
Disclosures: Benjamin R. Birney, MD: No financial relationships or conflicts of interest
Case Diagnosis: Polymyositis
Case Description: A 26-year-old female with a past medical history of polymyositis and fatty liver was admitted to ARF for increasing weakness, requiring assistance with ADLs and ambulation over two months. She presented with 3/5 bilateral upper extremity and 4/5 bilateral lower extremity motor strength. Her functional status was notable for maximal assist for ambulation. On admission, her laboratory tests showed CPK levels of 290 U/L and an Aldolase of 23 U/L. She was treated with IVIG x 2 doses in hospital, and methylprednisolone before being transitioned to prednisone at ARF. Metoprolol was started for consistent tachycardia related to the polymyositis flare.
Setting: Inpatient Rehabilitation UnitAssessment/
Results: The patient made great progress in acute rehabilitation. Upon discharge, the patient was pain-free, independent function with ADLs, and ambulating with a rolling walker. CPK level on discharge was 71 U/L, from 290 U/L and aldolase levels were 3.1 U/L, from 23 U/L.
Discussion: Polymyositis (PM) is a rare systemic inflammatory autoimmune myopathy characterized by insidious weakness in the proximal muscles, leading to physical debility and poor quality of life. Based on previous studies on healthy patients it was thought that physical exercise could exacerbate inflammation, based on serum levels of muscle enzymes (Creatine Kinase [CK]).2 Moreover, recent studies show evidence that exercise following acute disease exacerbation can be beneficial and tolerable in PM patients, as was seen in our patient. It is commonly accepted that CK and aldolase levels tend to indicate disease and can allow for an assessment of progress. Treatment for PM is based on glucocorticoids, immunosuppressive drugs, and physical exercise.
Conclusion: Polymyositis is a rare systemic inflammatory myopathy that can efficiently be treated medically in combination with rehabilitation, with the latter resulting in considerable attainment of ADLs and quality of life.
Level of Evidence: Level V
To cite this abstract in AMA style:
Birney BR, Bartels L, Korlipara A. The Importance and Improvement of Rehabilitation in Chronic Polymyositis: A Case Report [abstract]. PM R. 2021; 13(S1)(suppl 1). https://pmrjabstracts.org/abstract/the-importance-and-improvement-of-rehabilitation-in-chronic-polymyositis-a-case-report/. Accessed November 21, 2024.« Back to AAPM&R Annual Assembly 2021
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/the-importance-and-improvement-of-rehabilitation-in-chronic-polymyositis-a-case-report/