Physical Exercise in Myasthenia Gravis: A Systematic Review

Area of Science:

• Neurology
• Rehabilitation Medicine
• Autoimmune Diseases

Background:

• Myasthenia gravis (MG) is a chronic autoimmune condition causing progressive muscle weakness and fatigue.
• Historically, exercise was contraindicated in MG due to fears of symptom exacerbation.
• Emerging evidence suggests structured exercise may be safe and beneficial for stable MG patients.

Purpose of the Study:

• To systematically review the evidence on exercise and physical activity interventions in MG.
• To evaluate the effectiveness, safety, and impact on functional outcomes, fatigue, and quality of life (QoL).

Main Methods:

• Systematic review following PRISMA guidelines.
• Searched databases (PubMed, Web of Science, etc.) for studies from 2015-2025.
• Assessed methodological quality using the Downs and Black checklist.

Main Results:

• Eight controlled studies included aerobic, resistance, and respiratory muscle training.
• Exercise interventions were generally well-tolerated with no sustained symptom exacerbation.
• Aerobic and combined programs improved functional capacity and strength; respiratory training improved pulmonary function.

Conclusions:

• Individualized, symptom-guided exercise is likely safe and effective for stable MG.
• Regular physical activity can reduce deconditioning and enhance QoL.
• High-quality RCTs with longer follow-up are needed to solidify recommendations.