Oefeningen bij polymyositis (PM) — gegradeerde weerstand + aerobic VERBETERT kracht + verhoogt GEEN CK (Alexanderson 2014/2019)

Bohan & Peter 1975 + Lundberg 2017 EULAR/ACR + Dalakas 2015 + Selva-O'Callaghan 2018 framework. Polymyositis is an adult-onset (rarely children) idiopathic inflammatory myopathy presenting with symmetric proximal weakness + dysphagia + interstitial lung disease (ILD) risk + raised creatine kinase (CK). The key clinical contrast: distinct from dermatomyositis (DM) by the ABSENCE of characteristic skin manifestations (Gottron papules, heliotrope rash, photosensitive eruption); distinct from inclusion body myositis (IBM) by RESPONSIVENESS to immunosuppression and the symmetric proximal (not asymmetric finger-flexor + knee-extensor) pattern. First-line treatment: corticosteroids + methotrexate or azathioprine ± IVIg ± rituximab. ILD subtypes (often anti-synthetase syndrome overlap, even though anti-Jo-1/PL-7/PL-12 are technically markers of PM) may need cyclophosphamide or mycophenolate. CANCER SCREENING IS MANDATORY if onset >50 per Hill 2001 + Selva-O'Callaghan 2010 — the association is lower than in DM but real, and age-appropriate cancer screening (mammogram, colonoscopy, CT chest/abdomen/pelvis per local protocols) is high-impact. Exercise framework per Alexanderson 2014/2019 + de Souza 2016: graded resistance + aerobic IMPROVES strength + DOES NOT worsen CK or histologic inflammation — overturned the historical 'don't exercise inflamed muscle' framing. Steroid-induced osteoporosis + diabetes + cataracts + infection risk modify nutrition + lifestyle planning.

Volya's catalogue carries the foundation moves: supported-glute-bridge for posterior chain low-intensity activation (proximal weakness pattern is the PM presentation), wall-push-up for upper-body push at low load, scapular-retraction for upper-back posture, cat-cow for spinal mobility, supine-knee-to-chest for low-back release + hip flexor stretch, diaphragmatic-breathing for respiratory + ILD-aware training, seated-march for cardio without joint impact, sit-to-stand for functional + bone-loading + steroid-bone counter, chin-tuck for cervical posture + dysphagia swallow training. The AI coach also knows the nutrition side — anti-inflammatory Mediterranean + omega-3 1-2 g + colourful polyphenols, protein 1.4-1.6 g/kg + leucine 2.5-3 g per meal supports gains from exercise (which IS safe), steroid-protective low-GI Mediterranean + glucose monitoring + low-sodium + Ca + vit D + DEXA + B12/folate, dysphagia SLP + soft moist textures + chin-tuck swallow + sit upright 30+ min, ILD risk adequate caloric + protein, infection prevention on immunosuppression (food safety + AVOID unpasteurised), creatine 3-5 g modest benefit (Chung 2007), AVOID ultra-processed + SSBs + alcohol + restrictive fad diets. CRITICAL: The Myositis Association (TMA) + Myositis Support and Understanding + Cure JM (juvenile cases) + ACR + rheumatology + neurology + SLP if dysphagia + pulmonology if ILD + oncology + age-appropriate cancer screening if onset >50 + dietitian + PT/OT. This is NEVER a replacement for PM-experienced multidisciplinary care.