Abstract Details

Title Walking Away from Myasthenia Gravis

Topic Muscle Disease/Neuromuscular Junction

Presentation(s) P02 - (-)

Poster/Presentation
Number 208

Objective

Background BACKGROUND: Fatigue often limits activities of daily living in myasthenia gravis (MG); physical inactivity leads to deconditioning and compounds disability and fatigue.

Design/Methods DESIGN/METHODS: We enrolled 7 MG patients in a 3-month (1 hour, 3 days/week) program with aerobic walking, breathing, and Theraband resistance training. Open circuit spirometry during peak exercise testing determined fitness (V02 peak), portable metabolic monitoring measured steady state oxygen consumption during 6-minute walks (Gait Economy) at baseline and after training. Ventilatory capacity was determined during VO2 peak and Economy tests and maximum ventilatory capacity. We measured 10 m gait speed, daily steps, leg strength, and fatigue severity. Fatigue was rated on visual analog scale and Fatigue Severity Scale. Paired t-tests determined exercise mediated changes, p <0.05 was statistically significant. Relationships between variables were determined by linear regression analyses with Pearson correlation coefficients.

Results RESULTS: Training progressed across 3 month without adverse events. Aerobic progression: 10 to 30 minutes, 2.4 to 3.4 mph, and incline 0 to 3%. Fitness did not significantly increase 22.3 vs. 23.6 ml/kg/min, however workload increased (37%[uarr] speed and 30% [uarr]MET) and ventilatory exchange increased (L/min, 19%[uarr]). Metabolic cost of gait was high for MG subjects, requiring 67% of peak exercise capacity, 14.9 ml/kg/min; but training improved gait economy by 25%[darr] with lower ventilatory exchange (24%[darr]) and heart rate demand (16%[darr]). Functional gains included increased gait speed (28%), 6-minute walk distance (17%), daily step count (21%), and strength (15%), while Fatigue Severity decreased (24%).

Conclusions CONCLUSIONS: Our supervised training study program is well tolerated and safely produces 4-fold > higher workload capacity. Fitness and functional gains from this pilot study are promising and support further investigations of exercise to improve fitness, gait efficiency, and functional performance for MG patients.

Authors/Disclosures
Charlene E. Hafer-Macko, MD (Univ of Maryland) PRESENTER	No disclosure on file
Richard F. Macko, MD (University of Maryland School of Medicine)	No disclosure on file
Robyn E. Massa, MD (MainLine Health)	No disclosure on file
Chalita C. Atallah, MD	No disclosure on file
	No disclosure on file
Daniel Kaufer, MD, FAAN	No disclosure on file

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