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Therapeutic Challenges and Opportunities in Myopathy Management: A Narrative Review

Document Type : Review Article

Authors

1 Student Research Committee, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran

2 Department of Physiotherapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran

10.30476/jrsr.2025.106543.1565

Abstract

Background: Myopathies are a heterogeneous group of muscle disorders that affect more than 1.7 billion people worldwide and present significant therapeutic challenges because of their diverse etiologies, clinical manifestations, and varying degrees of disease severity.
Methods: This narrative review examines current therapeutic approaches for myopathies, including herbal remedies, complementary therapies such as acupuncture and massage, physiotherapy, nutritional interventions, and emerging gene therapies. Herbal remedies and complementary therapies may provide symptomatic relief for some patients, whereas physiotherapy helps preserve muscle function and improve physical performance. Nutritional interventions support overall health and may contribute to disease management, while gene therapies offer promising strategies to target the underlying genetic defects in inherited myopathies. However, the effectiveness of these interventions varies, and robust clinical evidence supporting many of these approaches remains limited.
Results: Herbal remedies and complementary therapies may provide symptomatic relief for some patients, whereas physiotherapy helps preserve muscle function and improve physical performance. Nutritional interventions support overall health and may contribute to disease management, while gene therapies offer promising strategies to target the underlying genetic defects in inherited myopathies. However, the effectiveness of these interventions varies, and robust clinical evidence supporting many of these approaches remains limited.
Conclusion: This review highlights the need for future research to prioritize large-scale, high-quality clinical trials to establish the safety and efficacy of existing and emerging therapies, develop personalized treatment strategies tailored to individual patient characteristics, and improve access to innovative therapeutic options. Addressing these challenges may enhance the clinical management of myopathies and ultimately improve patient outcomes and quality of life across diverse populations.

Keywords

References
  1. LaPelusa A, Asuncion RM, Kentris M. Muscular dystrophy. StatPearls. 2024.
  2. Daniel E, Smith IC, Ly V, Bourque PR, Breiner A, Lochmuller H, et al. Direct and indirect costs of idiopathic inflammatory myopathies in adults: A systematic review. Plos one. 2024;19(7):e0307144.
  3. Tieland M, Trouwborst I, Clark BC. Skeletal muscle performance and ageing. Journal of cachexia, sarcopenia and muscle. 2018;9(1):3-19.
  4. Nagy H, Veerapaneni KD. Myopathy, 2022.
  5. Sebbag E, Felten R, Sagez F, Sibilia J, Devilliers H, Arnaud L. The world-wide burden of musculoskeletal diseases: a systematic analysis of the World Health Organization Burden of Diseases Database. Annals of the rheumatic diseases. 2019;78(6):844-8.
  6. Barohn RJ, Dimachkie MM, Jackson CE. A pattern recognition approach to the patient with a suspected myopathy. Neurologic clinics. 2014;32(3):569.
  7. Moghadam-Kia S, Aggarwal R, Oddis CV. Treatment of inflammatory myopathy: emerging therapies and therapeutic targets. Expert review of clinical immunology. 2015;11(11):1265-75.
  8. Patwardhan A. The value of intravenous immunoglobulin therapy in idiopathic inflammatory myositis in the current transformed era of biologics. Cureus. 2020;12(2).
  9. Dalmia S, Sharma R, Ramaswami U, Hughes D, Jahnke N, Cole D, et al. Enzyme replacement therapy for late‐onset Pompe disease. Cochrane Database of Systematic Reviews. 2023(12).
  10. Bak K, Moon S, Ko M, Choi YJ, Shin S. Impact of metformin on statin‐associated myopathy risks in dyslipidemia patients. Pharmacology Research & Perspectives. 2023;11(4):e01114.
  11. Li N, Zhao H. Role of carnitine in non-alcoholic fatty liver disease and other related diseases: an update. Frontiers in medicine. 2021;8:689042.
  12. Ravenscroft G, Bryson-Richardson R, Nowak K, Laing N. Recent advances in understanding congenital myopathies. F1000Res. 2018; 7: F1000 Faculty Rev-1921.
  13. Aina A, Barbero M, Cagnie B, Castelli E, Cook C, Ferrari S, et al. 5th National Congress of the Italian Society of Physiotherapy: Milan, Italy. 3–4 October 2015. Archives of Physiotherapy. 2016;6:1-42.
  14. Horvath R, Kemp JP, Tuppen HA, Hudson G, Oldfors A, Marie SK, et al. Molecular basis of infantile reversible cytochrome c oxidase deficiency myopathy. Brain. 2009;132(11):3165-74.
  15. Tan H-l, Chan E. Respiratory care in myotubular myopathy. ERJ Open Research. 2021;7(1).
  16. North KN, Wang CH, Clarke N, Jungbluth H, Vainzof M, Dowling JJ, et al. Approach to the diagnosis of congenital myopathies. Neuromuscular disorders. 2014;24(2):97-116.
  17. Balke M, Teschler M, Schäfer H, Pape P, Mooren FC, Schmitz B. Therapeutic potential of electromyostimulation (EMS) in critically ill patients—a systematic review. Frontiers in physiology. 2022;13:865437.
  18. Piseru E-A, Piseru T, Miron A-R, Poboroniuc M-S, editors. Fostering Upper Limb Recovery through Interdisciplinary Collaboration: A Review of Robotic Devices, Functional Electrical Stimulation, and Mirror Therapy. 2024 IEEE International Conference And Exposition On Electric And Power Engineering (EPEi); 2024: IEEE.
  19. Addinsall AB, Cacciani N, Backeus A, Hedstöm Y, Larsson L. Electrical Stimulated Glut4 Trafficking Reduces Critical Illness‐Associated Muscle Wasting. The FASEB Journal. 2022;36.
  20. von Deneen KM, Alemayehu DG, Khosla A. Acute Compartment Syndrome and Rhabdomyolysis Caused by a Single Electrical Muscle Stimulation in a 46-Year-Old Female Professional Athlete With Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Disorder: A Case Report. Clinical Journal of Sport Medicine. 2022:10.1097.
  21. Liu Y, Guo C, Liu S, Zhang S, Mao Y, Fang L. Eight weeks of high-intensity interval static strength training improves skeletal muscle atrophy and motor function in aged rats via the PGC-1α/FNDC5/UCP1 pathway. Clinical Interventions in Aging. 2021:811-21.
  22. Ansved T. Muscle training in muscular dystrophies. Acta physiologica scandinavica. 2001;171(3):359-66.
  23. Bischoff HA, Roos EM. Effectiveness and safety of strengthening, aerobic, and coordination exercises for patients with osteoarthritis. Current opinion in rheumatology. 2003;15(2):141-4.
  24. Van Kleef ES, Langer D, Van Engelen BG, Ottenheijm CA, Voermans NC, Doorduin J. Inspiratory muscle training in nemaline myopathy. Journal of Neuromuscular Diseases. 2023;10(5):825-34.
  25. Corrado B, Ciardi G, Lucignano L. Supervised physical therapy and polymyositis/dermatomyositis—a systematic review of the literature. Neurology international. 2020;12(3):77-88.
  26. Pettersson H, Alexanderson H, Poole JL, Varga J, Regardt M, Russell A-M, et al. Exercise as a multi-modal disease-modifying medicine in systemic sclerosis: An introduction by The Global Fellowship on Rehabilitation and Exercise in Systemic Sclerosis (G-FoRSS). Best practice & research Clinical rheumatology. 2021;35(3):101695.
  27. SHEIkH AM, Vissing J. Exercise therapy for muscle and lower motor neuron diseases. Acta Myologica. 2019;38(4):215.
  28. Chen W-T, Sun C, Zhou Y-B, Liu D-H, Peng Z-L, Chen J, et al. Evaluation on the effect of acupuncture on patients with sepsis-induced myopathy (ACU-SIM pilot study): A single center, propensity-score stratified, assessor-blinded, prospective pragmatic controlled trial. Medicine. 2020;99(21):e20233.
  29. Liang F, Chen R, Nakagawa A, Nishizawa M, Tsuda S, Wang H, et al. Low‐frequency electroacupuncture improves insulin sensitivity in obese diabetic mice through activation of SIRT1/PGC‐1α in skeletal muscle. Evidence‐Based Complementary and Alternative Medicine. 2011;2011(1):735297.
  30. Seong K-M, Yu D-S, Choi B-S, Heo R-K, Jang M-J, Lee I-Y, et al. A Case Report of MELAS syndrome Improved by Oriental Medicine Treatment. Herbal Formula Science. 2010;18(2):267-77.
  31. Guo Y, Li Y, Xu T, Zhu MX, Xu Z, Dou B, et al. An inspiration to the studies on mechanisms of acupuncture and moxibustion action derived from 2021 Nobel Prize in Physiology or Medicine. Acupuncture and Herbal Medicine. 2022;2(1):1-8.
  32. Ko JH, Kim S-N. MicroRNA in acupuncture studies: does small RNA shed light on the biological mechanism of acupuncture? Evidence‐Based Complementary and Alternative Medicine. 2019;2019(1):3051472.
  33. Mitchell LKH, Koh RB, Nevarez JG. Successful treatment of a cervical injury and myopathy using integrative medicine techniques in an eclectus parrot (Eclectus roratus) following cervical entrapment. Journal of Avian Medicine and Surgery. 2023;37(2):175-9.
  34. Sokka T. SP0073 Markers of premature mortality: Poor physical fitness and performance. Annals of the Rheumatic Diseases. 2012;71:19.
  35. Chen S-C, Ho Y-S, Suen LK-P, Yu J, Tang W, Jiang J-F, et al. Traditional Chinese medicine (TCM) massage for the treatment of congenital muscular torticollis (CMT) in infants and children: a systematic review and meta-analysis. Complementary Therapies in Clinical Practice. 2020;39:101112.
  36. Islam SS, Lima RA. A Case Report on Bronchial Asthma with Myopathy. Archives of Clinical and Medical Case Reports. 2022;6(1):72-7.
  37. Yoshida T, Delafontaine P. Mechanisms of IGF-1-mediated regulation of skeletal muscle hypertrophy and atrophy. Cells. 2020;9(9):1970.
  38. Dalal N, Naranje K, Moriangthem A, Singh A. L-tyrosine for treatment of an infant with nemaline rod myopathy. BMJ Case Reports CP. 2024;17(6):e259303.
  39. Agoncillo M, Yu J, Gunton JE. The role of vitamin D in skeletal muscle repair and regeneration in animal models and humans: a systematic review. Nutrients. 2023;15(20):4377.
  40. Sun L-H, Huang J-Q, Deng J, Lei XG. Avian selenogenome: response to dietary Se and vitamin E deficiency and supplementation. Poultry Science. 2019;98(10):4247-54.
  41. Bomer N, Pavez‐Giani MG, Grote Beverborg N, Cleland JG, van Veldhuisen DJ, van der Meer P. Micronutrient deficiencies in heart failure: Mitochondrial dysfunction as a common pathophysiological mechanism? Journal of Internal Medicine. 2022;291(6):713-31.
  42. Kantasrila R, Pandith H, Balslev H, Wangpakapattanawong P, Panyadee P, Inta A. Medicinal plants for treating musculoskeletal disorders among Karen in Thailand. Plants. 2020;9(7):811.
  43. Fernández-Lázaro D, Mielgo-Ayuso J, Seco Calvo J, Córdova Martínez A, Caballero García A, Fernandez-Lazaro CI. Modulation of exercise-induced muscle damage, inflammation, and oxidative markers by curcumin supplementation in a physically active population: a systematic review. Nutrients. 2020;12(2):501.
  44. Laitano O, Pindado J, Valera I, Spradlin RA, Murray KO, Villani KR, et al. The impact of hindlimb disuse on sepsis‐induced myopathy in mice. Physiological Reports. 2021;9(14):e14979.
  45. Rajendran A, Elumalai V, Kumar PV, Elumalai K. Harnessing Traditional Chinese Medicine for Myopathy: A Comprehensive Review of Herbal Therapeutics. Pharmacological Research-Modern Chinese Medicine. 2024:100557.

 

Journal of Rehabilitation Sciences & Research
Volume 13, Issue 3
September 2026
Pages 205-210
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