高強度トレーニングが炎症性筋疾患に有効(High-intensity training improves muscle function in inflammatory muscle disease)

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2025-11-28 カロリンスカ研究所(KI)

Karolinska Institutet の研究チームは、まれな自己免疫性筋疾患群である Idiopathic inflammatory myopathies(IIM)患者を対象に、従来推奨されていた軽〜中強度の在宅運動に代えて、High‑Intensity Interval Training(HIIT)を導入した臨床試験を実施した。被験者23名を、週3回の静止バイクによるHIIT群と中等強度在宅運動群に無作為割り付けし、12週間の介入を行った。結果、HIIT群では有酸素能力が平均16%向上したのに対し、対照群は約1.8%にとどまった。また筋持久力も顕著に改善し、骨格筋のミトコンドリア機能改善の兆候が筋組織サンプルで確認された。さらに、炎症マーカーの悪化や筋損傷の兆候は認められず、病状も安定したままだった。これにより、IIM患者に対してHIITは安全かつ効果的な運動療法であり、従来以上に持久力/筋機能を改善する現実的選択肢になりうる可能性が示された。

<関連情報>

高強度インターバルトレーニングは、最近発症した特発性炎症性筋疾患患者の有酸素能力を改善するために中等度の運動よりも優れている:多施設ランダム化比較試験 High-intensity interval training outperforms moderate exercise to improve aerobic capacity in patients with recent-onset idiopathic inflammatory myopathies: a multicentre randomised controlled trial

Kristofer M. Andreasson ∙ Cecilia Leijding ∙ Maryam Dastmalchi ∙ Antonella Notarnicola ∙ Stefano Gastaldello ∙ Takashi Yamada ∙ et al.
eBiomedicine  Published: November 27, 2025
DOI:https://doi.org/10.1016/j.ebiom.2025.106051

高強度トレーニングが炎症性筋疾患に有効(High-intensity training improves muscle function in inflammatory muscle disease)

Summary

Background

To investigate efficacy, safety, and tolerance of high-intensity interval training (HIIT) vs. clinical standard low-moderate intensity home-based exercise (CON) to improve aerobic capacity, muscle endurance, and mitochondrial function in patients with recent onset, idiopathic inflammatory myopathies (IIM).

Methods

Twenty-three patients with recent onset IIM were randomised into HIIT or CON groups. Both groups underwent 12 weeks of exercise training. The HIIT did 3 sessions/week, always supervised during the first three weeks. Then, training was supervised 1–3 session per week based on an individual assessment of the participants’ preference and ability to perform HIIT in the clinic. The CON received one supervised session and then exercised five days per week at home, following clinical standard. Primary outcome was maximal exercise test (VO2peak l/min and ml/kg x min, peak power (Watt), time-to-exhaustion TTE min/sec), with secondary outcomes mitochondrial protein expression in muscle. Safety was assessed by disease activity (serum levels of muscle enzymes, muscle strength (MMT8), Physician Global Assessment, pain, and fatigue (VAS, 0–100).

Findings

HIIT resulted in a 16% increase in VO2peak L/min, significantly higher than the 1.8% change in CON (95% CI 0.1; 0.47). Peak power and TTE improved significantly more in HIIT, 18% and 23%, respectively, compared to CON, 8% and 12% (95% CI 3.9; 30.8 and 00:06; 03:18, respectively). Muscle biopsies (HIIT n = 7, CON n = 6) showed increases (p < 0.05) in central mitochondrial protein expression in HIIT but not CON, suggesting enhanced mitochondrial function. Both groups maintained stable serum muscle enzymes indicating no increase in disease activity from the intervention. Muscle disease activity remained low and unchanged in both groups (95% CI -1.2; 1.0), physician global activity and MMT8 significantly improved within CON (95% CI -1.7; -0.26 and 0.1; 3.9, respectively) but not in the HIIT group.

Interpretation

HIIT is an effective and safe exercise intervention to improve aerobic fitness, muscle endurance, and mitochondrial function in patients with recent onset IIM. This approach should be considered an adjuvant treatment in managing IIM, potentially health-enhancing for these patients.

Funding

Swedish Research Council, the Swedish Rheumatism Association, Stockholm County Research Grant (ALF), King Gustaf V 80-year Foundation, the Swedish Heart and Lung Foundation, Promobilia Foundation, and Stig Thune Foundation.

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