Intermittent aerobic exercise programs improve functional capacity and decrease fatigue and kinesiophobia in patients with generalized myasthenia gravis (MG), according to findings published in Annals of Medical Research.

Although exercise increases inflammation as evidenced by elevated cytokine levels and repeated muscle contractions in MG, it also decreases the release of tumor necrosis factor-α, which contributes to the pathogenesis of the disease. Prolonged exercise also decreased the autoimmune response in patients with MG, therefore, these observations indicated that long-term, monitored, aerobic exercise programs may influence MG symptoms.

Researchers analyzed how aerobic exercise programs impacted 9 patients with generalized MG, including functional and aerobic capacity, fatigue levels, kinesiophobia, and disease severity as measured by the 6-Minute Walk Test (6MWT), the Exercise Tolerance Test (ETT), the Multidimensional Fatigue Scale, the Tampa Kinesiophobia Scale, and the Quantitative MG Score.

Results of the ETT determined maximal oxygen consumption based on a calculated speed for each patient. The patient then exercised at safe intervals which did not trigger MG episodes for 20 to 30 minutes per day for 5 days each week, following a 10-minute warm-up along with breathing exercises. Additionally, light strengthening, balance, and posture exercises were incorporated into the program as tolerated.

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Patient age and MG disease duration had no significant impact on kinesiophobia, fatigue, or maximal oxygen consumption. The researchers observed inverse relationships between maximal oxygen consumption and kinesiophobia (P =.020, r =-.750) and fatigue (P =.031, r =-.714). As maximal oxygen consumption increased, kinesiophobia and fatigue decreased.

Conversely, a positive correlation existed between maximum aerobic capacity and the distance walked on the 6MWT (P =.013, r =.783). As patients improved their aerobic capacity, their exercise tolerance and functional capacity also improved, allowing them to walk increased distances.

“An aerobic exercise program with intervals could be applied safely under supervision in patients with generalized MG,” the authors concluded. “Patients’ functional capacity increased, fatigue and fear of movement decreased.”


Karaahmet OZ, Gurcay E, Uz FB, Tombak Y, Ates MP, Altinsoy S. The impact of aerobic exercise on fatigue, kinesiophobia and disease severity in myasthenia gravis patients. Ann Med Res. 2022; 29(5):515-518. doi:10.5455/annalsmedres.2021.09.563