RESUMEN
Anti-signal recognition particle myositis (ASRPM) is a steroid-resistant disease that develops in approximately 5-8％ of patients with dermatomyositis, polymyositis, or other types of myositis. It restricts the patient's activities of daily life (ADLs), mainly owing to muscle weakness of the trunk and proximal lower extremities. We report a case of ASRPM treated at a Kaifukuki rehabilitation ward (KRW；a type of inpatient rehabilitation ward in Japan). A female ASRPM patient in her eighties underwent treatment at the KRW twice, with an interval of 18 months between treatments. During each hospital stay, concentrative and graded exercise therapy was performed under continuous administration of steroid and tacrolimus hydrate. The severity of ASRPM was evaluated using periodic measurement of creatinine kinase (CK) levels. After each KRW treatment, the patient gained the ability to walk and perform instrumental ADLs to live alone. The details of exercise therapy for ASRPM and the management of ASRPM and steroid-induced osteoporosis and its complications (for e.g., lumbar compression fracture) are also discussed.
RESUMEN
Isho-ho was used to successfully treat three cases of muscular weakness. The first case was a 59-year-old woman. In May of 1993, she began to suffer from a feeling of general lethargy. The condition was diagnosed as multiple myositis, and prednisolone was administered. However, since she still experienced loss of strength in the lower limbs, she was introduced to the authors' department for treatment in August of 1994. Administration of Isho-ho improved the loss of strength in the lower limbs and increased her grip strength.<br>The second case was a 42-year-old woman who complained of unusual sensations in the tips of her fingers and toes starting in mid-September, 1994. In November of the same year, she began to experience a loss of strength in the limbs. In February of 1995, the condition was diagnosed as chronic inflammatory demyelinatory multiple neuropathy by the same department, and large doses of steroids were administered. Although this treatment delayed the loss of strength in the lower back and legs, actual improvement in the condition did not occur until Isho-ho was given.<br>The third case involved a 63-year-old man who began to experience a loss of strength in the lower limbs in 1984. In 1988, the loss of strength became pronounced. In June of the same year, he sought treatment at the authors' department, and the condition was diagnosed as bulbar myelinic muscular atrophy. In October of 1993, he was unable to get out of bed unassisted, and was admitted to the authors' department. He was given Isho-ho, and reported a decrease in the feeling of a loss of strength in the lower limbs, and a disappearance of greater pectoral muscle spasms. These results suggest that Isho-ho is not only effective for loss of strength in the lower limbs, but may also be efficacious for loss of strength, numbness and muscle spasms in the upper limbs.