Sport and Exercise in Myasthenia Gravis

1. Sport and Exercise
in
Myasthenia Gravis
Ade Wijaya, MD – July 2020

2. INTRODUCTION
Autoimmune
Disease
Acethylcholine
Receptors
Neuromuscular
Juntions
Prevalence: 50-
125 per million
Affect QOL due
to fatique and
weakness
Drachman DB. Myasthenia gravis. N. Engl. J. Med. 1994; 330: 1797–810.
Kurtzke JF, Kurland LT. Chapter 66: the epidemiology of neurologic disease. In: Joynt RJ, editor. Clinical Neurology. Rev. Ed. Vol. 4 . Philadelphia: J.B. Lippincott; 1992. p. 80–8.

3. Peak Onset
• Women in the second and third decade of life
peak age distribution that is common for sports
participation
• Men during their sixth and seventh decades

4. Nastuk, M.A. (2013). Myasthenia gravis. Magill’s Medical Guide, (Online Edition). 5 Scheer, B.V., Valero-Burgos, E., & Costa, R. (2012). Myasthenia gravis and endurance exercise. Am. J. Phys.
Med. Rehabil., 91(8). 725-727. 6 Myasthenia Gravis Association. (n.d.). Exercise, Heat, & Nutrition.

5. Clinical Manifestation
- General muscle weakness & fatigability
- Drooping eye lids
- Difficulty breathing
- Difficulty with chewing & swallowing
- Difficulty talking
FLUCTUATIVE
Cass, S. (2013). Myasthenia Gravis and Sports Participation. ACSM Current Sports medicine Reports, 12(1). 18-21.

6. PACE
• P- Planning daily activities
A- Adapting the home, adequate rest, assistive
equipment, asking for help
C- Conserving energy, check-ups with doctor,
cool temperature
E- Emotional stability, exercising in
moderation, eliminating unnecessary daily
tasks
PTC Physical Therapy. (n.d.). Exercise and myasthenia gravis.Retrieved from http:// www.my-physical-therapy-coach.com/exercise-and-myasthenia-gravis-mg.html

8. Aerobic
Exercise
Breathing
Exercise
Strength
Training
Cass, S. (2013). Myasthenia Gravis and Sports Participation. ACSM Current Sports medicine Reports, 12(1). 18-21.

9. • Aerobic activity at mild to moderate exertion on a
regular basis seems from the literature to improve MG
functional status and quality of life, as well as lead to
increased coping ability
• The literature is very sparse regarding strength training
in MG, noting that medications such as prednisone
may limit peak strength
• Breathing exercises in MG seem to be very effective for
improving quality of life and decreasing fatigability
Cass, S. (2013). Myasthenia Gravis and Sports Participation. ACSM Current Sports medicine Reports, 12(1). 18-21.

10. Activity Guidelines
Scheer BV, Valero-Burgos E, Costa R. Myasthenia gravis and endurance exercise. Am. J. Phys. Med. Rehabil. 2012; 91: 1–3
Becker A, Grohar-Murray ME, Reilly S, Ricci M. Self-care actions to manage fatigue among myasthenia gravis patients. J. Neurosci. Nurs. 1998; 30: 191–9.

11. Conclusion
Exercise is an important facet to improving the
quality of life of athletes and patients with MG
while also reducing their overall symptoms