Physical Training Effects in Myasthenia Gravis

El, Lohi; Lindberg, Christopher; Andersen, O.

doi:10.1016/s0003-9993(23)00011-4

Cited by 54 publications

(4 citation statements)

References 7 publications

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“…Lohi et al examined 11 MG patients with mild to moderate disease before and after an intensive muscle strength training program for 10 weeks [19]. They trained one arm and one leg, the other side serving as a control.…”

Section: Resultsmentioning

confidence: 99%

Physical training and exercise in myasthenia gravis

Gilhus

2021

Neuromuscular Disorders

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Section: Resultsmentioning

confidence: 99%

Physical training and exercise in myasthenia gravis

Gilhus

2021

Neuromuscular Disorders

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“…In contrast, the present study showed that moderate-to-intense RMT plus chest physiotherapy can have positive effects on postoperative respiratory vital capacity and ADLs in surgically treated MG patients. Previous studies have tested several rehabilitative approaches, including physical, respiratory, and balance training, with results suggesting that a multidisciplinary rehabilitation approach would be better than any single approach in patients with MG, especially those with mild to moderate symptomatology [ 6 , 7 , 9 , 27 – 34 ]. The benefits of respiratory training were shown to include not only measurable improvements in respiratory muscle strength, respiratory endurance, and physical performance [ 6 , 7 , 9 , 27 – 34 ].…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have tested several rehabilitative approaches, including physical, respiratory, and balance training, with results suggesting that a multidisciplinary rehabilitation approach would be better than any single approach in patients with MG, especially those with mild to moderate symptomatology [ 6 , 7 , 9 , 27 – 34 ]. The benefits of respiratory training were shown to include not only measurable improvements in respiratory muscle strength, respiratory endurance, and physical performance [ 6 , 7 , 9 , 27 – 34 ]. but also reductions in the incidence of several complications of MG, including dyspnea [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Preoperative respiratory muscle training combined with aerobic exercise improves respiratory vital capacity and daily life activity following surgical treatment for myasthenia gravis

Chen

et al. 2023

J Cardiothorac Surg

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Objective The effects of preoperative respiratory muscle training (RMT) on postoperative complications in patients surgically treated for myasthenia gravis (MG) remain unclear. The present study therefore evaluated the effects of preoperative moderate-to-intense RMT and aerobic exercise, when added to respiratory physiotherapy, on respiratory vital capacity, exercise capacity, and duration of hospital stay in patients with MG. Methods Eighty patients with MG scheduled for extended thymectomy were randomly divided into two groups. The 40 subjects in the study group (SG) received preoperative moderate-to-intense RMT and aerobic exercise in addition to respiratory physiotherapy, whereas the 40 subjects in the control group (CG) received only chest physiotherapy. Respiratory vital capacity (as determined by VC, FVC, FEV1, FEV1/FVC, and PEF) and exercise capacity (as determined by the 6-min walk test [6 MWT]) were measured pre- and postoperatively and before discharge. The duration of hospital stay and activity of daily living (ADL) were also determined. Results Demographic and surgical characteristics, along with preoperative vital capacity and exercise capacity, were similar in the two groups. In the CG, VC (p = 0.001), FVC (p = 0.001), FEV1 (p = 0.002), PEF (p = 0.004), and 6MWT (p = 0.041) were significantly lower postoperatively than preoperatively, whereas the FEV1/FVC ratio did not differ significantly. Postoperative VC (p = 0.012), FVC (p = 0.030), FEV1 (p = 0.014), and PEF (p = 0.035) were significantly higher in the SG than in the CG, although 6MWT results did not differ. ADL on postoperative day 5 was significantly higher in the SG than in the CG (p = 0.001). Conclusion RMT and aerobic exercise can have positive effects on postoperative respiratory vital capacity and daily life activity, and would enhance recovery after surgery in MG patients.

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“…An interventional study found improvement in muscle strength in 11 patients with MG during a supervised 10-week resistance training period [85]. Further studies on supervised aerobic and/or resistance training for 8-24 weeks found that exercise in MG was safe, well-tolerated, and positively influenced muscle strength and performance-based outcome measures [86][87][88][89][90].…”

Section: Physical Activity and Trainingmentioning

confidence: 99%

Generalized myasthenia gravis with acetylcholine receptor antibodies: A guidance for treatment

Gilhus,

Andersen,

Andersen

et al. 2024

Euro J of Neurology

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BackgroundGeneralized myasthenia gravis (MG) with antibodies against the acetylcholine receptor is a chronic disease causing muscle weakness. Access to novel treatments warrants authoritative treatment recommendations. The Nordic countries have similar, comprehensive health systems, mandatory health registers, and extensive MG research.MethodsMG experts and patient representatives from the five Nordic countries formed a working group to prepare treatment guidance for MG based on a systematic literature search and consensus meetings.ResultsPyridostigmine represents the first‐line symptomatic treatment, while ambenonium and beta adrenergic agonists are second‐line options. Early thymectomy should be undertaken if a thymoma, and in non‐thymoma patients up to the age of 50–65 years if not obtaining remission on symptomatic treatment. Most patients need immunosuppressive drug treatment. Combining corticosteroids at the lowest possible dose with azathioprine is recommended, rituximab being an alternative first‐line option. Mycophenolate, methotrexate, and tacrolimus represent second‐line immunosuppression. Plasma exchange and intravenous immunoglobulin are used for myasthenic crises and acute exacerbations. Novel complement inhibitors and FcRn blockers are effective and fast‐acting treatments with promising safety profiles. Their use depends on local availability, refunding policies, and cost–benefit analyses. Adapted physical training is recommended. Planning of pregnancies with optimal treatment, information, and awareness of neonatal MG is necessary. Social support and adaptation of work and daily life activities are recommended.ConclusionsSuccessful treatment of MG rests on timely combination of different interventions. Due to spontaneous disease fluctuations, comorbidities, and changes in life conditions, regular long‐term specialized follow‐up is needed. Most patients do reasonably well but there is room for further improvement. Novel treatments are promising, though subject to restricted access due to costs.

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Physical Training Effects in Myasthenia Gravis

Cited by 54 publications

References 7 publications

Physical training and exercise in myasthenia gravis

Physical training and exercise in myasthenia gravis

Preoperative respiratory muscle training combined with aerobic exercise improves respiratory vital capacity and daily life activity following surgical treatment for myasthenia gravis

Generalized myasthenia gravis with acetylcholine receptor antibodies: A guidance for treatment

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