Long-Term exercise intervention in patients with McArdle disease: clinical and aerobic fitness benefits

Introduction: The long-term effects of exercise in patients with McArdle disease—the paradigm of ‘exercise intolerance’—are unknown. This is an important question as the severity of the disease frequently increases with time. Purpose: To study the effects of a long-term exercise intervention on clin...

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Detalles Bibliográficos
Autores: Santalla Hernández, Alfredo, Valenzuela, Pedro L., Rodríguez López, Carlos, Rodríguez Gómez, Irene, Nogales, Gisela, Pinós Figueras, Tomás, Arenas, Joaquín, Martín, Miguel Ángel, Santos Lozano, Alejandro, Morán, María, Fiuza Luces, Carmen, Ara Royo, Ignacio, Lucia, Alejandro
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Universidad de Castilla-La Mancha
Repositorio:RUIdeRA. Repositorio Institucional de la UCLM
OAI Identifier:oai:ruidera.uclm.es:10578/29633
Acceso en línea:http://hdl.handle.net/10578/29633
Access Level:acceso abierto
Palabra clave:Myophosphorylase
Exercise is medicine
Glycogenosys type 5
Glycogen storage disease
Descripción
Sumario:Introduction: The long-term effects of exercise in patients with McArdle disease—the paradigm of ‘exercise intolerance’—are unknown. This is an important question as the severity of the disease frequently increases with time. Purpose: To study the effects of a long-term exercise intervention on clinical and fitness-related outcomes in McArdle patients. Methods: Seventeen patients (exercise group: N=10, 6 male, 38±18yrs; control: N=7, 4 male, 38±18yrs) participated in a twoyear unsupervised intervention including moderate-intensity aerobic (cycle-ergometer exercise for 1h) and resistance (high load-low repetition circuit) training on 5 and 2-3 days/week, respectively. Patients were assessed at baseline and postintervention. Besides safety, outcomes included clinical severity (e.g., exercise intolerance features) on a 0-3 scale (primary outcome), and aerobic fitness, gross muscle efficiency, and body composition (total/regional fat, muscle, and bone mass) (secondary outcomes). Results: The exercise program was safe and resulted in a reduction of one point (-1.0, 95% confidence interval -1.6—-0.5, p=0.025) in clinical severity vs. the control group, with 60% of participants in the exercise group becoming virtually asymptomatic and with no functional limitation in daily life activities. Compared with controls, the intervention induced significant and large benefits (all p<0.05) in the workload eliciting the ventilatory threshold (both in absolute (watts, +37%) and relative units (watts·kg-1 of total body mass or of lower-limb muscle mass, +44%)), peak oxygen uptake (ml·kg-1 ·min-1 , +28%) and peak workload (absolute (+27%) and relative units (+33%)). However, no significant changes were found for muscle efficiency nor for any measure of body composition. Conclusions: A two-year unsupervised intervention including aerobic and resistance exercise is safe and induces major benefits in the clinical course and aerobic fitness of patients with McArdle disease.