Exercices pour MCTD (syndrome de Sharp) — chaleur pour Raynaud + dépistage HTAP + programmation selon le trait dominant

Sharp 1972 + Alarcón-Segovia 1987 + Kasukawa 1987 classification criteria. Mixed connective tissue disease (MCTD, also Sharp syndrome) is defined by anti-U1-RNP antibody positivity + overlap features of systemic lupus erythematosus + systemic sclerosis + polymyositis/dermatomyositis + rheumatoid arthritis. The clinical picture varies with dominant feature: Raynaud's phenomenon (often severe + earliest, ~95%), arthritis, esophageal dysmotility (scleroderma-like), inflammatory myositis, ILD, and pulmonary arterial hypertension (PAH is the poor prognosis marker in MCTD — screening with echo + 6MWD is critical). Treatment shares the lupus + scleroderma + DM toolkit per dominant feature. Tani 2014 + Hoffmann-Vold 2024 reviews: graded aerobic + light strength training reduces fatigue + arthritis pain without flares. Exercise priorities reflect the overlap: warm extremities mandatory (Raynaud's universal + often severe — no cold-air exposure), PAH screening (echo + 6MWD + RHC if indicated) is critical BEFORE any aerobic prescription, daily hand-mobility ROM if scleroderma-like skin features, graded resistance + leucine + creatine if DM-like myositis features.

Volya's catalogue carries the foundation moves: supported-glute-bridge for posterior chain, wall-push-up for scaled upper-body + hand-loading (scleroderma-like), scapular-retraction for posture, cat-cow for spinal mobility, supine-knee-to-chest for low-back release, diaphragmatic-breathing for parasympathetic + ILD-aware breath control, pursed-lip-breathing for PAH/ILD dyspnea, standing-march for managed cardio (after PAH screen), ankle-pump for circulation + DVT. The AI coach also knows the nutrition side — Raynaud's (warm extremities + adequate calories during cold + omega-3 1-3 g/day microvascular), esophageal dysmotility (small frequent meals + sit upright 30+ min post-meal + soft+moist textures if dysphagia + SLP eval), myositis features (protein 1.4-1.6 g/kg/day + leucine 2.5-3 g per meal + creatine 3-5 g/day under rheum), PAH modifier low-sodium <2 g/day + cardiology team, ILD modifier omega-3 + Mediterranean + nutritional support if cachexia, AVOID alfalfa + echinacea + Spirulina (lupus-overlap immune-stimulant concern), vitamin D often low target 40-60 ng/mL, anti-inflammatory Mediterranean backbone (Tani 2014 + Hoffmann-Vold 2024), steroid-induced osteoporosis calcium 1000-1200 + weight-bearing, HCQ retinopathy screening per AAO 2016 if HCQ used. CRITICAL: Mixed Connective Tissue Disease Foundation + ACR + rheumatology + cardiology if PAH + pulmonology if ILD + GI/SLP if dysphagia + ophthalmology (HCQ retinopathy) + dietitian familiar with overlap CTDs. This is NEVER a replacement for rheumatology + multispecialty care.