Although they vary in particulars, polymyositis, dermatomyositis and inclusion body myositis are idiopathic inflammatory myopathies (IIM) primarily characterized by chronic inflammation of human skeletal muscle tissue that ultimately causes the necrosis of muscle cells. This degeneration leads to muscle tissue wasting, weakness and fatigue among other serious effects. Until recently, exercise has been avoided as a type of therapy, and even forbidden due to the risk of triggering or amplifying inflammation. However, several studies have been conducted to test this assumption and have shown that aerobic exercise as well as resistance training can maintain and even improve quality of life for IIM-affected individuals without increased inflammatory response. Modes of exercise therapy: trials With the main goals of treatment being improved functionality and quality of life, exercise programs should focus on "functional" exercises (e.g. walking, walking up/down stairs, sit-to-stand), when applicable. Performing functional exercises increases (a) the efficiency of the exercise program and (b) the likelihood the improvements will be transferred to activities of daily living. Isometric activity In 1993, isometric exercise training was applied for four weeks resulting in isometric peak power at 60% of maximal voluntary contraction. The increase in isometric power was later shown to have no significant effect on serum creatine kinase (CK) after two weeks of strength training. Aerobic activity A six-week training program in 1998 that included 30 minutes of aerobic activity three times per week set at 60% maximum heart rate (predicted by age) resulted in increased VO2 max (i.e. maximal oxygen consumption or aerobic capacity), diminished pain, reduced muscle impairment, and improved quality of life. Weight bearing activity The results produced by aerobic activity were repeated in 1999 where for 12 weeks, weight-bearing exercise was added for patients not exhibiting marked physical incapacity as measured by the Functional Index in Myositis (see Functional Assessment section). Confirmed by MRI and muscle biopsy, both the 1998 and 1999 studies showed that there were no significant changes in levels of creatine kinase and aldolase, and no increase in muscle inflammation. In 2001, 22 patients were placed on a three-week physical therapy and exercise program, and found that creatine kinase levels actually dropped in 20 of the patients. The longest study to date was a six-month exercise program demonstrating a significant improvement in exercise capacity, VO2, isokinetic strength, and the ability to perform daily tasks compared to controls. Stretching and range of motion activity Chest expansion and