AUTHOR=Crisafulli Oscar , Lacetera Jessica , Bottoni Giorgio , Berardinelli Angela , Grattarola Luca , Veltroni Martina , Acquadro Stefano , Negro Massimo , Lavaselli Emanuela , D’Antona Giuseppe TITLE=Case report: A creatine kinase-borg scale values-based approach to tailor physical training in a central core myopathy patient JOURNAL=Frontiers in Physiology VOLUME=15 YEAR=2024 URL=https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2024.1404657 DOI=10.3389/fphys.2024.1404657 ISSN=1664-042X ABSTRACT=Background

Patients with central core myopathy (CCM) can be at risk of exercise-induced rhabdomyolysis and myalgia. Despite its possible positive effects, physical training has been long avoided in these patients as no population-specific exercise adaption strategies have been developed. Here we present the case of a 17-year-old male CCM patient who underwent a 3-month training program tailored to a preliminary test aimed at assessing his physical exertion tolerance measured via changes in serum creatine kinase (CK).

Methods

The preliminary tolerance test consisted of three 25-minute sessions (one session per week) of physical exercise (aerobic, resistance and mixed) at an intensity quantified as level 6 of the Borg Category Ratio (CR) 0–10 scale. A blood sample to assess CK was conducted 36 h following eachsession. The intervention consisted of a training program (three sessions per week) including both resistance and aerobic exercises concomitant with a personalized nutritional plan. Before and after intervention, a battery of metabolic (indirect calorimetry, bioimpedance) and cardiopulmonary (CPET) tests were performed.

Results

After training, improvements of the anaerobic threshold (+6.9%), normalized VO2 max (+15%) and body composition (muscle mass, +1.1 kg; fat mass, −1.1 kg were observed without pain, rhabdomyolysis, and blood CK augmentation compared to pretraining values.

Conclusion

Our results highlight that a mixed aerobic/resistance training, properly tailored and supported by a specific nutritional plan, may safely improve the physical fitness and body composition in a CCM patient. Dosing exercise-induced CK serum change following Borg CR-10 intensity assessment, may be useful to correctly tailor physical exercise in these patients.