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Sarah Wright, DO MS, joined us on March 20 to discuss a hot topic in the MG Community: is it safe to exercise with myasthenia gravis?
Dr. Wright is a neurologist practicing at Children’s National in Washington, D.C., and she gets this question a lot from her young adult patients. To answer it, she dove into the published research and presented her findings as part of the MGFA’s Wellness Webinar series.
Dr. Wright’s main takeaway is that the published research supports the safety of exercise for MG patients with mild or moderate symptoms, and that there may even be benefits that can help manage the disease. Even light exercise can improve how you feel, both physically and mentally.
We highly encourage you to watch the full webinar, which includes a 30-minute presentation and 20 minutes of Q&A, but you can also find a recap with some of Dr. Wright’s slides below.
First, Dr. Wright shared that you should always discuss exercise with your doctor before starting any kind of work out or exercise regime. Everyone’s health situation is different.
Next, she shared an overview of the current approach to treating MG, which involves medications and other treatments, lifestyle modifications, and psychosocial support, but has not traditionally included exercise, as it was previously thought to be harmful to the muscles, particularly during times of active inflammation. This, of course, is because activating the muscle can lead to weakness in people with MG.
However, this is slowly changing, as research on myasthenia gravis in general becomes more prevalent.
“In the past ten years, there have been a lot more small trials looking at how exercise can potentially help myasthenia gravis,” Dr. Wright said. “It really does set us up for the future to figure out what’s the best regimen or exercise options for patients.”
She talked about studies that explored how exercising impacts a person’s body at the cellular level. In one study using mice, researchers found exercise helped with the remodeling of the neuromuscular junction. A different study looked at the anti-inflammatory effect of different exercises. Many other studies have shown the impact of endorphins (which are produced when you exercise) on pain, fatigue, and mood.
Recent studies have explored exercise specifically for MG patients, and most support the benefits of exercise, with the caveat that the sample size in the studies is small. Here are some of the studies that Dr. Wright referenced in her talk:
Dr. Wight summarized the findings from medical literature in the slide below:
Dr. Wright noted that breathing exercises are of special interest to people with MG because the literature shows that these exercises increase your capacity to take a deep breath. They have been shown to improve post-surgical outcomes and help people recover faster from intubation. She suggested patients work with a respiratory therapist or physical therapist to define some good exercises for people with MG. The American Lung Association also offers some helpful information about pulmonary rehabilitation.
Dr. Wight made sure to note that experts don’t have good recommendations for people with severe disease or with co-morbidities that may affect their health in other ways, as studies did not include these individuals. You should be especially cautious about starting an exercise regime if this applies to you.
For those with mild or moderate symptoms, based on the medical literature Dr. Wright recommends a workout regime similar to the slide below. She notes that this is a sample regimen and may not work for everyone. Some people living with MG are capable of much more intensive exercise, running marathons or triathlons, while others struggle to complete simple, every-day tasks. Everyone’s health is different, and she encouraged patients to take their own status into account when tackling the exercise question.
Before starting an exercise program, Dr. Wight recommends getting an opinion from your doctor. She recommends asking following questions:
