Hidetoshi Yanagi, Naohisa Shindo
Department of Cardiovascular Rehabilitation, National Cerebral and Cardiovascular Center, Osaka, Japan. E-mail: h.yanagi@ncvc.go.jp
DOI: 10.2340/16501977-2206

Background: A 42-year-old woman with chronic polymyositis complicated by post-myocarditis cardiomyopathy underwent supervised and unsupervised exercise therapy with staged increases in intensity.
Methods: Supervised exercise therapy, which included adopted standards for patients with heart failure, was performed for 6 months. After one month, unsupervised exercise therapy was commenced, in the form of 15 min walking, the duration of which was increased to 30 min after 2 months.
Results: Improvements in muscle strength, balance, gait velocity, and exercise tolerance were observed, with no exacerbation of myositis or heart failure. At 6 months, the level of physical activity reached that of an age-matched healthy person.
Conclusion: With appropriate care to avoid exacerbation of heart failure and myositis, staged increases in the volume of supervised and unsupervised exercise therapy can safely and effectively maintain and improve physical capacity, exercise tolerance, and overall physical activity.

Little has been reported about exercise therapy for polymyositis patients with heart failure. A 42-year-old woman with chronic polymyositis complicated by post-myocarditis cardiomyopathy received inpatient and home exercise therapy, with staged increases in intensity from standards for heart failure patients. It was performed with no worsening of myositis or heart failure and is, thus, safe and effective.