Long-Term Respiratory Muscle Endurance Training in Patients with Myasthenia Gravis: First Results after Four Months of Training

Abstract

Myasthenia gravis (MG) is characterized by reduced muscle endurance and is often accompanied by respiratory complications. Improvement of respiratory function is therefore an important objective in MG therapy. A previous study demonstrated that respiratory muscle endurance training (RMET) over four weeks increased respiratory muscle endurance of MG patients to about 200% of baseline. The purpose of the present study was to establish an appropriate maintenance training and to test its effects over four months. Ten patients with mild to moderate MG participated in this study. During the first month, they performed five training sessions per week. For the following 3 months, training frequency was reduced to five sessions per two weeks. Myasthenia score, lung function, and respiratory endurance were determined prior to training, after the first month, and after 4 months. Myasthenia score improved from 0.71 ± 0.1 to 0.56 ± 0.1 (P = 0.007). Respiratory endurance time increased from 6.1 ± 0.8 to 20.3 ± 3.0 min (P < 0.001). In conclusion, this RMET maintenance program is feasible and is significantly beneficial for MG patients.

Respiratory muscle endurance after training in athletes and non-athletes: A systematic review and meta-analysis

“…Respiratory muscle endurance (RME) has been evaluated over the years in a wide range of patient populations such as spinal cord injury (Silva, Neder & Chiurciu, 2000) chronic obstructive pulmonary disease (COPD) (Dias et al,2013;Weiner et al,2003), myasthenia gravis (Rassler et al, 2011), as well as in healthy individuals (Johnson, Cowley, Kinnear, 1997;Spengler, Roos, Laube et al, 1999;Johnson, Sharpe & Brown, 2007;Bell et al, 2013). This evaluation has been used as an outcome measurement following different treatment interventions and to determine normative values for respiratory muscle performance (Fiz, Romero, Gomez et al, 1998;Verges, Boutellier, & Spengler, 2008;Kroff & Terblanche, 2010;Fischer, Tarperi, George et al,2014.…”

Respiratory Muscle Training Improves Functional Outcomes and Reduces Fatigue in Patients with Myasthenia Gravis: A Single-Center Hospital-Based Prospective Study

“…For a statistical power of 80% and the significance level of 5%, a sample size of 18 participants was calculated to determine a 15% change in myasthenia score improvement [5]. To avoid the influence of age, sex, and body mass index on the pulmonary function [10,11], sixteen age-, sex-, and BMI-matched MG patients who were not willing to undergo RMT were included as disease controls.…”

“…Class V is defined by the need for intubation, with or without mechanical ventilation, except when used during routine postoperative management. The effect of RMT may be performed safely and effectively in mild to moderate MG patients (classes II and III) with impairment of respiratory function [5,6].…”

“…A previous study demonstrates that home-based respiratory muscle training (RMT) combined with breathing retraining in patients with generalized MG leads to improvements in respiratory muscle strength, chest wall mobility, and respiratory muscle endurance but does not appear to improve lung function [5,7]. Lung function parameters such as vital capacity (VC), forced expiratory volume in one second (FEV1), and maximal expiratory pressure (MEP) are based on short maneuvers requiring maximal effort.…”

Respiratory Muscle Training for Respiratory Deficits in Neurodegenerative Disorders

“…The heterogeneity of of daily living, which further contributes to muscle weakness. 7,18 Pulmonary function in neurodegenerative disorders of the CNS is generally characterized by reduced inspiratory and expiratory pressure and a restrictive spirometric pattern. 1,16,19 At early stages of disease, there are only slight abnormalities in pulmonary function; however, at later stages, when there is considerable muscle weakness, vital capacity and FVC are reduced dramatically.…”