The effectiveness of exercise on patients with myasthenia gravis

Abstract

Overview of topic: MG is an autoimmune disease in the postsynaptic membrane at the neuromuscular junction. The main symptom of the disease is muscular weakness and fatigue and it may involve respiratory muscles and thus effecting ventilation. This study investigated the effect of exercise on patients with MG disease because it is stated that physical training programs increase muscle strength, and on the other hand, MG worsens with increased repetitive movements. Research question: Using the PICO framework; P (people with MG), I (exercise), C (no exercise), O (positive effect), the following research question was formulated: “In myasthenia gravis, does exercise when compared to no exercise have a positive effect on people?’’. Search methods: Literature search was conducted with the use of HyDi, PubMed, Google Scholar and Scopus databases. For a specific search, key terms and combination of alternative terms were used, together with an inclusion and exclusion criteria of full text peer-reviewed English articles dating from 2012 onwards. The result yielded six studies; one systemic review, two RCT’s and three cohort studies. These key studies were appraised with the appropriate CASP tools (refer to Appendix) to assess validity and applicability to patient care. Results: The six studies showed a statistical significance on the positive effect of exercise as an interventional therapy to people with MG disease. However, all studies suggested that further research must be conducted with a larger sample size and longitudinal studies in order to sustain the results. Conclusion: The literature review concluded that exercise does provide a positive effect in people with MG disease. Hence both the patients and health professionals should be informed by providing short courses to improve their knowledge besides adding it as a subject in the nursing curriculum. More research is needed as such studies in Malta are very limited.