Facilitators and barriers to exercise in autoimmune myasthenia gravis: A cross-sectional survey study

IntroductionKnowledge about facilitators and barriers to exercise among individuals with MG is limited.ObjectiveThe aim of this study was to identify factors that influence exercise participation for adults with MG and to explore beliefs and perceptions with respect to exercise.MethodsThis was a cross-sectional observational study via an online questionnaire. Adults with MG residing in France were eligible.ResultsResponses from 455 participants were analysed. The majority were between 50 and 69 years, 71% were female, 80% had generalised MG, and half had early-onset MG. Participants reported reduced MG-specific QoL (MGQOL-15F-r), a moderate-to-high impact of MG on activities of daily living (MG-ADL), and mild-to-moderate fatigue levels (NeuroQoL fatigue). Overall, 54% of respondents reported engaging in exercise ("exercisers"), while 47% did not ("non-exercisers"). Exercisers had a lower BMI, reported less fatigue, better HRQoL and a lower impact of MG on ADLs compared to non-exercisers. Fear of exercising was reported by one-third of participants, including half of non-exercisers versus 19% of exercisers (p < 0.001). Non-exercisers reported significantly more barriers to exercise (mean 3.5 (1.8)) than exercisers (mean 2.6 (1.9), p < 0.001). Health/symptoms was the most frequently reported barrier in both groups (59% of non-exercisers, 39% of exercisers). Non-exercisers also reported fewer facilitators (mean 2.1 (1.4)) than for exercisers (mean 2.5 (1.3), p=0.004). The most frequently cited facilitator for non-exercisers was specialised supervision/coaching (59%), while exercisers most frequently cited health/symptom improvement (57%).ConclusionSeveral barriers and facilitators influencing exercise participation for individuals with MG could be addressed with tailored programmes.