Home-based exercise in autoimmune myasthenia gravis: A randomized controlled trial

Area of Science:

• Neurology
• Rehabilitation Medicine
• Clinical Immunology

Background:

• Limited evidence exists on exercise tolerance and its impact on quality of life in myasthenia gravis (MG).
• Generalized autoimmune myasthenia gravis (gMG) is a chronic condition affecting quality of life.

Purpose of the Study:

• To assess the tolerability and efficacy of exercise as an adjunct therapy for improving health-related quality of life (HRQoL) in stabilized gMG patients.
• To evaluate the effects of a home-based rowing exercise program on clinical, psychological, and immunological markers.

Main Methods:

• A multi-center, prospective randomized controlled trial (RCT) was conducted.
• Participants with stabilized gMG were randomized to usual care or usual care plus a 3-month home rowing program (3x weekly, 40 min sessions).
• The primary endpoint was the change in HRQoL (MGQOL-15-F); secondary endpoints included exercise tolerance and clinical status.

Main Results:

• Forty-five patients were randomized (23 to exercise, 20 to usual care).
• The exercise intervention was well tolerated.
• No significant difference in HRQoL was observed between the exercise and usual care groups (mean adjusted difference -0.8 points).
• Two hospitalizations for MG exacerbation occurred in the usual care group.

Conclusions:

• While exercise is safe and well-tolerated in stabilized gMG, it did not demonstrate a significant benefit for HRQoL in this study.
• Further research may be needed to explore optimal exercise parameters or patient subgroups that could benefit.