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Near-infrared spectroscopy during exercise and recovery in children with juvenile dermatomyositis
G Esther A Habers1, Rogier De Knikker, Marco Van Brussel
1Child Development and Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Room KB.02.056.0, P.O. Box 85090, NL-3508 AB Utrecht, The Netherlands.
Insights
Children with juvenile dermatomyositis (JDM) show impaired muscle blood volume regulation during exercise. This suggests microvascular dysfunction contributes to reduced exercise capacity in JDM patients.
Area of Science:
- Pediatric Rheumatology
- Exercise Physiology
- Clinical Medicine
Background:
- Juvenile dermatomyositis (JDM) is associated with reduced exercise capacity.
- Microvascular disturbances in muscle tissue are hypothesized to contribute to this limitation.
Purpose of the Study:
- To investigate muscle microvascular function during exercise in children with JDM.
- To compare exercise capacity and muscle oxygenation between JDM patients and controls.
Main Methods:
- Near-infrared spectroscopy (NIRS) was used to measure muscle oxygenation (Δ[O2 Hb], Δ[tHb]) in vastus muscles.
- Participants performed a maximal incremental cycloergometric test.
- Children with JDM, juvenile idiopathic arthritis, and healthy children were included.
Main Results:
- Children with JDM exhibited lower Δ[tHb] in the vastus medialis at all exercise intensities compared to healthy children.
- The typical increase in muscle blood volume with increasing exercise intensity was absent in JDM patients.
- No significant differences were observed in other measured outcomes.
Conclusions:
- Children with JDM may have impaired ability to increase muscle blood volume during strenuous exercise.
- These findings support the role of microvascular dysfunction in reduced exercise capacity in JDM.
Introduction:
We hypothesized that microvascular disturbances in muscle tissue play a role in the reduced exercise capacity in juvenile dermatomyositis (JDM).
Methods:
Children with JDM, children with juvenile idiopathic arthritis (clinical controls), and healthy children performed a maximal incremental cycloergometric test from which normalized concentration changes in oxygenated hemoglobin (Δ[O2 Hb]) and total hemoglobin (Δ[tHb]) as well as the half-recovery times of both signals were determined from the vastus medialis and vastus lateralis muscles using near-infrared spectroscopy.
Results:
Children with JDM had lower Δ[tHb] values in the vastus medialis at work rates of 25%, 50%, 75%, and 100% of maximal compared with healthy children; the increase in Δ[tHb] with increasing intensity seen in healthy children was absent in children with JDM. Other outcome measures did not differ by group.
Conclusions:
The results suggest that children with JDM may experience difficulties in increasing muscle blood volume with more strenuous exercise.
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