EFFECTS OF EXERCISE, CREATINE & COQ10 ON MUSCLE FUNCTION IN CHILDREN WITH MYOSITIS
Juvenile idiopathic inflammatory myopathies (JIIM) are characterized by chronic inflammation of skeletal muscles, muscle weakness and skin rashes. Patients with JIIM have impaired energy metabolism which contributes to the pathophysiology of debilitating muscular symptoms. Creatine (Cr) and Coenzyme Q10 (CoQ10) supplementation, compounds involved in cellular metabolism, has been shown to improve outcomes in musculoskeletal diseases similar to JIIM. Although exercising with Cr supplementation has demonstrated improved muscle function in adults with myositis, its efficacy in children is uncertain. CoQ10 has not yet been used as a therapeutic supplement for myositis. The primary aim of this study was to evaluate whether supplementation with Cr+CoQ10, combined with an exercise program, enhances muscle function in children with juvenile idiopathic inflammatory myopathy (JIIM), as measured by the Wingate Test. Secondary objectives included assessing improvements in vertical jump height, disease activity, and quality of life (QoL), as reported by clinicians, patients, and parents through questionnaires. We recruited 15 patients aged 8-18 from the JIIM specialty clinic at SickKids to participate in a 6-month randomized, double-blind, placebo-controlled, multiple baseline trial. Data were analyzed using a randomization test. The intervention group demonstrated significant mean differences in peak power (mean difference (MD) = 93.99 Watts; p = 0.0268), mean power (MD = 72.68 Watts; p = 0.0265), and minimum power (MD = 47.29 Watts; p = 0.0119) on the Wingate Test, compared to the placebo group. Additionally, a significant mean difference in vertical jump peak power (MD = 642.91 Watts; p = 0.0145) was observed favoring the intervention. However, these results were not replicated when analyzed using linear mixed models, which account for trends in data before and after the intervention. These results suggest that while the initial findings are promising, even with these significant p-values, they may be due to chance rather than a true effect of the intervention. Further research is needed to explore the impact of creatine and CoQ10 supplementation in children with JIIM.BACKGROUND
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