The impact of aerobic exercise on fatigue, kinesiophobia and disease severity in myasthenia gravis patients
The impact of aerobic exercise on fatigue, kinesiophobia and disease severity in myasthenia gravis patients
Aim: To determine the aerobic capacity of generalized myasthenia gravis (MG) cases and to explore the effect of aerobic exercise on maximum aerobic capacity, fatigue level, kinesiophobia, and disease severity parameters. Materials and Methods: The seropositive-confirmed generalized MG cases who were between the ages of 18 and 80 years and between 2-4 stages, at the same time hospitalized in the physical therapy and rehabilitation clinic for three weeks were included in this study. Outcome measures of the 6-minute walk test (6MWT), the ergospirometric cardiopulmonary stress test (ETT), the multidimensional fatigue scale (MFS), the Quantitative Myasthenia Gravis Score (QMG) and, the Tampa kinesophobia scale (TKS) were evaluated at admission and discharge. Results: A negative correlation between VO2 max and kinesophobia and fatigue (p= 0.020, r= -0.750; p= 0.031, r= -0.714, respectively) was determined, while a positive correlation was recorded between VO2 max and 6-MWT (r= 0.783 p= 0.013). Conclusion: Intermittent aerobic exercise programs can be safely administered under supervision in generalized MG patients. The functional capacity of the patients increased, fatigue and fear of movement decreased. Registration: The Ethics Committee in the University of Health Sciences, Diskapi Training and Research Hospital confirmed the study (Protocol #91/05 Dated 06.07.2020).
___
- 1. Silvestri NJ, Wolfe GI. Myasthenia Gravis. Semin Neurol. 2012;32:215.
- 2. Keesey JC. Clinical evaluation and management of myasthenia gravis. Muscle & Nerve: Official Journal of the American Association of Electrodiagnostic Medicine. 2004;29(4):484-505.
- 3. Jones, L.A., Robertson, N.P. An update on treatments in myasthenia gravis. J Neurol. 2017;264:205–207.
- 4. Schepelmann K, Winter Y, Spottke AE, Claus D, Grothe C, Schröder R, et al. Socioeconomic burden of amyotrophic lateral sclerosis, myasthenia gravis and facioscapulohumeral muscular dystrophy. J Neurol. 2010;257:15-23.
- 5. Twork S, Wiesmeth S, Klewer J, Pöhlau D, Kugler J. Quality of life and life circumstances in German myasthenia gravis patients. Health Qual Life Outcomes. 2010;8:129.
- 6. Leonardi M, Raggi A, Antozzi C, Confalonieri P, Maggi L, Cornelio F, et al.
- 7. Disability and functional profiles of patients with myasthenia gravis measured with ICF classification. Int J Rehabil Res. 2009;32:167-72.
- 8. Nils E. Gilhus. Myasthenia Gravis. N Engl J Med. 2016;375:2570- 81.
- 9. Lee JS, Jook IS, Seok JI. Widely varying TNF-alpha levels in patients with myasthenia gravis. Neurol Sci. 2009;30:259-62.
- 10. Suzuki K. Cytokine Response to Exercise and Its Modulation. Antioxidants. 2018;7:17.
- 11. Sanders DB, Wolfe GI, Benatar M, Evoli A, Gilhus NE, Illa I, et al. International consensus guidance for management of myasthenia gravis: Executive summary. Neurology. 2016;87(4):419- 25.
- 12. Guyatt GH, Sullivan MJ, Thompson PJ, Fallen EL, Pugsley SO, Taylor DW, et al. The 6-minute walk: a new measure of exercise capacity in patients with chronic heart failure. Can Med Assoc J. 1985 Apr 15;132(8):919-23.
- 13. Yildirim Y, Ergin G. A Validity and reliability study of the Turkish Multidimensional Assessment of Fatigue (MAF) scale in chronic musculoskeletal physical therapy patients. Back Musculoskelet Rehabil. 2013;26:307-16.
- 14. Tunca Yılmaz O., Yakut Y., Uygur F. ve Ulug N. Tampa Kinezyofobi Olcegi’nin Turkce Versiyonu ve Test Tekrar Test Guvenirligi. Fizyoterapi Rehabilitasyon Dergisi 2011;22:44-9.
- 15. Jaretzki 3rd A, Barohn RJ, Ernstoff RM, Kaminski HJ, Keesey JC, Penn AS, et al. Myasthenia gravis: recommendations for clinical research standards. Task Force of the Medical Scientific Advisory Board of the Myasthenia Gravis Foundation of America. Neurology. 2000;55:16-23.
- 16. Sharshar T, Chevret S, Mazighi M, Chillet P, Huberfeld G, Berreotta C, et al. Validity and reliability of two muscle strength scores commonly used as endpoints in assessing treatment of myasthenia gravis. J Neurol. 2000;247(4):286–90.
- 17. Breiner A, Widdifield J, Katzberg HD et al. Epidemiology of myasthenia gravis in Ontario, Canada. Neuromuscular Disord. 2016;26:41
- 18. Heyward, V. Advanced Fitness Assessment & Exercise Prescription (3rd Ed). Champaign, IL: Human Kinetics, 1997.
- 19. Rahbek MA, Mikkelsen EE, Overgaard K, Vinge L, Andersen H, Dalgas U. Exercise in Myasthenia Gravis: A Feasibility Study of Aerobic and Resistance Training. Muscle Nerve. 2017;56:700-9.
- 20. Westerberg E, Molin CJ, Lindblad I, Emtner M, Punga AR. Physical Exercise in Myasthenia Gravis Is Safe and Improves Neuromuscular Parameters and Physical Performance-Based Measures: A Pilot Study. Muscle Nerve. 2017;56:207-14.
- 21. Birnbaum S, Sharshar T, Eymard B, Theaudin M, Portero P, Hogrel JY. Marathons and myasthenia gravis: a case report. BMC Neurol. 2018;18:145.