Community exercise is feasible for neuromuscular diseases and can improve aerobic capacity

Abstract

Objective: The aim of this phase 2 trial was to ascertain the feasibility and effect of community-based aerobic exercise training for people with 2 of the more common neuromuscular diseases: Charcot-Marie-Tooth disease type 1A (CMT) and inclusion body myositis (IBM).

Methods: A randomized single-blinded crossover trial design was used to compare a 12-week aerobic training program using recombinant exercise bicycles compared to a control period. The training occurred 3 times per week in community gyms local to the participants. Support was available from trained gym staff and a research physiotherapist. The 2 disease groups were analyzed separately. The primary outcome measure was peak oxygen uptake (VO₂ peak) during a maximal exercise test, with secondary measures of muscle strength, function, and patient-reported measures.

Results: Data from 23 people with CMT and 17 people with IBM were included in the analysis. Both disease groups had high levels of participation and demonstrated improvements in VO₂ peak, with a moderate effect size in the CMT participants (Cohen d = 0.53) and a strong effect size in the IBM group (Cohen d = 1.72). No major changes were observed in the secondary outcome measures. Qualitative interviews revealed that participants valued the support of gym instructors and the research physiotherapists in overcoming challenges to participation.

Conclusion: Twelve weeks of aerobic training in community gyms was feasible, safe, and improved aerobic capacity in people with CMT and IBM.

Classification of evidence: This study provides Class II evidence that for patients with CMT type 1A and IBM, an aerobic training program increases aerobic capacity.

Figure 1. Consolidated Standards of Reporting Trials diagram

Recruitment, enrollment, allocation, and retention details of participants for the (A) (CMT) and (B) (IBM) groups. BP = blood pressure; ITT = intent-to-treat.

Figure 2. Effect of training and control interventions

Line graphs of mean VO₂ peak (mL/min/kg) for the Charcot-Marie-Tooth disease type 1A (CMT) group (A); VO₂ peak for the inclusion body myositis (IBM) group (B); work rate (W) for the CMT group (C); work rate for the IBM group (D). Error bars are SD, solid lines represent change with the 12-week intervention/control periods, dotted lines represent change during the 8-week reversal period at crossover.