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Dr Selwyn Richards

• Meeting Report in Newsletter 59, October 2005
• Meeting Report in Newsletter 48, September 2000

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Meeting Report printed in Newsletter 59 October 2005 based on a talk given by Dr Selwyn Richards at the Myositis Support Group Meeting 2005

Dr Selwyn Richards from Poole Hospital (you may recall Selwyn spent some of his earlier years with the team at Kings Collage London) is a strong advocate for the benefits of exercise, whether you have Myositis or not. Many members enjoyed his light hearted talk that was referred to by one or our members in jest as a sermon! We would all like to take his advice but of great concern to Myositis sufferers is whether the exercise will do any further damage to the muscles. Overall, exercise is strongly recommended but that doesn’t mean a 5 mile dash! Everything should be gradual and rest days should be implemented. People who exercise tend to live healthier lifestyles, eat well, do not smoke, or drink large quantities of alcohol. Exercise releases ‘feel good’ chemicals into the body and overall general mood is lifted.

Dr Richards gave a presentation on his work that he was performing at Kings College. Exercise can improve the symptoms associated with myositis. Regular exercise as well as increasing a positive mood can also improve the symptoms of pain and fatigue. It has been demonstrated that aerobic exercise can increase peoples pain threshold so they require less analgesics and are able to perform more exercise thus gradually overcome persistent fatigue. The benefits of improving pain and fatigue by exercise are common to all conditions but there is no clear medical explanation to how this is achieved.

At present there is little published work into the effects of exercise on myositis however exercise is unlikely to do any harm. Indirect evidence supports improving myositis and direct evidence demonstrates that there is no worsening of myositis with exercise. In myositis there are two types of exercise that should be considered and these are centred on improving the patients strength and their overall fitness. Exactly how much exercise a myositis sufferer should undertake to improve strength and fitness levels is unknown. Considering the individuals type of myositis, current activity of disease, current level of fitness, and lifestyle, etc., is important. If a patient is able to perform exercise Dr Richards can see no harm in performing 30 minutes exercise up to 5 times a week (equivalent of the ACSM exercise advice 1997 for a healthy individual).

Exercise could be gentle strength exercises performed in the home and whilst sat in a chair. The patient should start gently and slowly and gradually build up to more active exercise. Doing routine living things for oneself can be considered exercise, For example, getting out of the bed, making a cup of tea and gradually building up on day to day activities. In doing them yourself it is a positive step towards more active exercise such as, taking a walk in the garden, to the end of the road, to the next street, etc.

There is no evidence that says that exercise worsens active myositis, but nor does it say it makes it better. In Dr Richard’s opinion doing things for yourself, e.g., increasing the amount of day to day activities that are performed can be considered as low intensity exercise levels and recommended.

It is important to have rest days in between days of exercise/activity and there is clear evidence for this as exercise puts extra stress on your muscles. Resting on alternate days should enable a sufferer to perform maximum exercise activity for longer.

In conclusion exercise improves the ability to cope with the pain and fatigue symptoms of myositis thus, helps patients cope more confidently with their disease.

The current trial at Kings College involves exercise and creatine. A lady from the floor informed that she had been on the exercise programme at Kings and now leads a much more active life and would whole heatedly encourage other sufferers to give it a try.

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