Exercise and Myasthenia Gravis: A Review

Abstract

Myasthenia gravis (MG) is characterized by weakness and fatigability of the voluntary muscles.  Weakness in the muscles is worsened by exercise and relieved by rest.  Some patients are told to refrain from any form of exercise or strenuous activity, while others are told to be as physically active as possible.  There is not a general exercise prescription recommended for these patients.  Symptoms of MG often lead to a sedentary lifestyle associated with the development of other diseases such as diabetes, obesity, and heart disease.  Some common medications used for MG can increase the risk for these diseases.  There is scant literature on the use of exercise in this population, however, the limited data does indicate that physical activity can provide benefits for these patients.

We reviewed the pathophysiology, classification, weakness patterns, etiology, medical management, and treatment of MG.  We describe many studies on the responses to exercise in MG patients including resistance training, respiratory muscle training, aerobic & ischemic exercise studies, along with several case studies.  Though there is still a dearth of data, it appears the effects of exercise on patients with MG mirror those of healthy persons, with possible improvements in strength, aerobic and respiratory capacity and functional activities.