Myasthenia Gravis and Physical Therapy

Myasthenia Gravis

According to medical research studies, Myasthenia Gravis is an autoimmune disease that develops when an individual’s immune system makes certain antibodies that affect its tissues. The antibodies produced by the body destroy or block muscle receptors that are fundamental in communication between the nerve-to-muscle and muscle contraction. The receptors are often referred to as acetylcholine (National Institute of Neurological Disorders and Stroke, 2010). The condition results in weakness of muscles and the effects tend to increase a lot when one is involved in physical activity that only reduces after resting. The most important fact to note is that the degree by which muscle weakness occurs due to myasthenia differs greatly among the affected individuals. The difference ranges from a localized form that is only limited to ocular myasthenia to a more severe form in which other muscles, such as those that control breathing, are affected (Daniel, 1994).

In the traditional context, the condition has often been regarded to affect both genders and all ethnic groups. The most common cases are often found in younger women under the age of 40 and older men over the age of 60, although the condition can occur at any given age within the population. Epidemiological studies done in Greece found a Female to a Male ratio of 41:1, while the one in Asia indicated a ratio of 2:1, further confirming the female preponderance of this condition (Daniel, 1994). There are varied symptoms related to this condition. The first symptom, often experienced, is the muscle fatigue, especially after engaging in a physical exercise. Other symptoms include difficulty in the movement of eye and eyelid, difficulty in swallowing and slurred speech, as a result of fatigue in the muscle responsible for speech. A recent study in Demark indicates that 27% of the general population, affected by this condition, often dies, which reflect an average annual crude mortality rate of 1.4 per million. In general, the crisis caused by this condition has dropped in the past four decades from a high mortality rate of 30% to 0% currently (Christensen et al., 1998).

Physical Therapy for Myasthenia Gravis

Myasthenia gravis greatly impact on the functional ability of the patients. The condition affects the ability of the eye and eyelids of a patient to move freely by causing fatigue on the muscle that controls movement of these parts (Daniel, 1994). As earlier stated among the symptoms, the other functional abilities of the patient that are negatively impacted by the condition include the ability to talk, chew and swallow. Further progression of the condition causes a patient to have difficulty in holding his head up, walking on a stair and, in extreme cases, raising a patient’s arms (National Institute of Neurological Disorders and Stroke, 2010). There are various medical treatments that have been used and are currently being used to manage the disease. The used treatments include a recommendation for a lifestyle change, use of corticosteroids, application of plasmapharesis and the use of surgical thymectomy (Cathy, 2002). Although most of these diagnoses have been fundamental, the aspect of using Physical therapy to manage the disease is rarely explored by the patient. Physical therapy in a generalized context defines a therapy, applied by the use of mechanical movement or force. The study done at Massachusetts General Hospital indicates that neuromuscular junction’s disorders, such as myasthenia syndrome and Myasthenia Gravis, constitute a treatable and important class of diseases that require physical therapy and rehabilitation medicine to manage (Week, 2013). There are two forms of physical therapy that are often recommended to patients according to a study by Fregonezi, Resqueti, Güell, Pradas, and Casan (2005) which focused on the physical therapy for people with generalized Myasthenia Gravis. The two forms of physical therapy include physical exercise and the breathing exercise.

Physical Therapy Exercise

The most vital component of physical therapy to a Myasthenia Gravis patient is the use of physical exercise. Several questions have been raised, based on the use of physical exercise as a good therapy for the condition, and, in most cases, the answer has been absolute that exercising is a good thing for Myasthenia Gravis patients (Fregonezi et al., 2005). In case of applying physical therapy exercise, it is the duty of the therapist to design an exercise program that will focus majorly on strengthening the particular muscle that has been weakened by the condition. For example, the physical therapist might suggest that the patient undertakes squats to strengthen the hamstring muscle and quadriceps. Other forms of exercise that he might recommend include leg raises, so as to add more strength to the hip and abdominal muscles. In a case when the muscles are very weak, it is the duty of the physical therapist to provide assistance to the patient in times of exercise (Lohi, Lindberg, & Andersen, 1993). The study concludes that application of interval based Inspiratory Muscle Training is very effective and feasible to Myasthenia Gravis patients, as it improves the patient’s strength in respiratory muscles and increases the mobility of chest wall (Fregonezi et al., 2005).

Breathing Exercise

According to the study, the demonstration carried out using the diaphragmatic and breathing retraining exercise showed a further improvement in respiratory pattern. Furthermore, pursed-lip breathing aids in releasing the air that is trapped in the lungs, thereby easing the shortness of one’s breath. In general, the exercise is significant in improving the breathing muscles.

Based on various studies, the major observation undertaken is that muscular exercise, when added with another exercise, such as aerobics, walking, running and jogging has high chances of being effective for patients who suffer from muscle disorder (Lohi et al., 1993). The most important factor to note by a patient is that one must be very cautious when engaging in any exercise. The patient must put into consideration the type of exercise, the time of the day for doing the exercise and the general environmental condition in which the exercise is bound to take place.

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