One small study found that muscle and body function improved in patients with clinically stable myasthenia gravis (MG) who participated in a customized six-month exercise program.
The exercise program, which combined aerobic and strength training with stretching, was well tolerated by all participants.
“Exercise is safe, effective and suitable for patients with well-regulated MG,” the study authors write.
The study “Changes in Physical Fitness and Body Composition Associated with Exercise in Patients with Myasthenia Gravis: A Prospective Longitudinal Study” was published by a team of researchers in Taiwan in the Journal of Clinical Medicine.
MG patients experience periods of muscle weakness due to an autoimmune attack on certain proteins involved in nerve-muscle communication. Muscles can become unusually tired and weak, especially after exercising.
However, there is evidence that exercise can actually reduce fatigue and help build muscle strength. A well-planned exercise program can help patients maintain their physical fitness so that they can more easily carry out their daily activities.
However, “it remains unknown how physical activity affects body composition, disease function and the severity of the disease,” the researchers wrote.
To learn more, investigators conducted a study that included 35 patients with clinically stable MG who had been on the same medication for at least six months. There were a total of 13 men and 22 women with an average age of 56 years and an average duration of illness of 12 years.
According to the Myasthenia Gravis Foundation of America (MGFA) scale, a tool used to assess the severity and clinical characteristics of MG, 21 patients (60%) had Type II MG (mild muscle weakness) and 14 patients (40%) a type III MG (moderate muscle weakness).
The researchers developed an exercise program based on general recommendations for healthy adults. Each session began with a five-minute warm-up, followed by seven training cycles of three minutes each and a final five-minute cool-down period that lasted about 30 minutes in total.
Training exercises included squats, standing up exercises, stretching with arms outstretched, squat jumps, sprinting on the spot, and exercises with your own body weight. A series of stretching exercises followed. The training intensity was adjusted to the physical ability of each patient.
All patients were directed to have a monthly session under the supervision of a researcher. Then they were told to exercise at home as often and as long as they wanted. As part of the study, they were asked to record the number of sessions completed and their duration.
To evaluate the effectiveness of the training program, the researchers evaluated several clinical and physical measures before and after completing a training period of 24 weeks (approx. Six months).
Grip Strength – a measure of the force a person can exert – increased for both right and left hands and the total QMG value. This quantitative measure of the severity of the disease decreased from 10.5 to 9.0.
The body composition did not change with the exercise program. This result was assessed using Whole Body Dual Energy X-ray Absorptiometry (DXA), an imaging test that measures bone density, as well as the amount of muscle mass and fat, by transmitting X-rays containing two different energy levels through the body.
The patients completed a median of three training units per week and spent a median of 56 minutes (almost one hour) training per week.
When the researchers divided the patients into two groups based on whether they were exercising above or below the weekly median, they found that patients who exercised more also lost more muscle mass in their arms. However, they also saw greater improvements in forced vital capacity – a measure of lung function – and walking speed compared to people who exercised less each week.
In the group of patients who did more exercise, the total QMG score decreased from 9.4 to 6.6, indicating an improvement in symptom severity. This improvement was not seen in the group of patients who exercised less.
The researchers also divided the patients into two additional groups based on disease severity, which was assessed using the overall QMG score. They found that patients with a QMG score of 10 or less experienced greater improvements in walking speed than patients with a QMG score greater than 11.
“The results show that exercise can be safe and beneficial for functional outcomes in patients with MG,” the researchers wrote.
“In the absence of an established and effective training plan for patients with MG, there is a need to develop an exercise plan to improve exercise function in these patients, and full-body DXA could be a potential tool for monitoring outcomes in patients with MG after exercise “They concluded.