Myasthenia gravis is a neuromuscular disease linked to the deleterious effects of autoantibodies directed against elements of the neuromuscular junction, mainly the acetylcholine receptor located in the postsynaptic region. This common disease results in typically fluctuating paralysis initially predominant in the eye muscles with possible generalization to other muscle groups, as well as greater fatigue. While treatment with anticholinesterase drugs is generally effective on symptoms, especially ocular and bulbar symptoms, background therapy is often required. As in many other neuromuscular diseases, the question of the harmful or beneficial effect of physical exercise arises in this condition.
In an article published in December 2020, a Norwegian neurologist provides an update on the subject based on a review of the literature. Ten studies caught his attention and involved 159 patients with generalized myasthenia gravis. Muscle training programs used in a variety of modalities have been shown not only to be well tolerated but also to be effective in improving muscle strength in a sustainable manner, provided they are performed regularly. The feeling of fatigue, on the other hand, seems less sensitive to this beneficial effect. The author stresses the need to build such tailor-made programs and to convince the patient to invest in the long run.