Physical Therapy Management of Myasthenia Gravis: A Case Study

Authors

Erin Hung, Kaiser Permanente Rehabilitation Services EducationFollow
Gwendolyn Juha, Kaiser Permanente Rehabilitation Services EducationFollow
Todd E. Davenport, University of the PacificFollow
Joy Williams, University of the PacificFollow

Abstract

Purpose: Myasthenia gravis (MG) is an autoimmune disease that involves dysfunction of the neuromuscular junction, and commonly involves fluctuating muscle weakness and central fatigue. Current literature lacks consensus on the benefit of exercise in addressing central fatigue in this population. This case report explores the role of physical therapy in an individual with MG for whom fatigue is a primary concern. Methods: This case study describes the physical therapy management of a 62-year-old Caucasian male recently diagnosed with myasthenia gravis. Physical therapy intervention focused on strength and balance training as well as patient education on energy conservation and activity pacing. Diaphragmatic breathing and coordination of interdisciplinary referrals were also incorporated. Results: The patient demonstrated improved functional strength per the 5 Times Sit to Stand, and improved standing balance per the Modified Clinical Test of Sensory Interaction in Balance. The patient’s 6 Minute Walk Test did not indicate improved endurance. Subjectively the patient mentioned ongoing fatigue, and although his MFIS and FSS scores improved, these measures do not have established MDC or MCID values for the MG population. Conclusion: The results of this case are consistent with current literature, suggesting that physical therapy interventions can improve strength and balance in patients with MG, but not necessarily fatigue. Further research is needed to determine optimal management of fatigue in MG.

Author Bio(s)

Erin Hung, PT, DPT is a licensed physical therapist at Kaiser Permanente Santa Clara Medical Center in Santa Clara, California, United States

Gwendolyn Juha, PT, MPT is a Clinical Specialist Physical Therapist at Kaiser Permanente Redwood City Medical Center and a faculty member within the Kaiser Permanente Rehabilitation Services Education.

Todd Davenport, PT, PhD, DPT, MPH is Scholarly Projects Coordinator, Kaiser Permanente Northern California Rehabilitation Services Education, Oakland, California, United States and Professor & Vice Chair, Department of Physical Therapy, School of Health Sciences, University of the Pacific, Stockton, California, United States

Joy Williams, PT, DPT is board certified clinical specialist in neurologic physical therapy, a faculty member of Kaiser Permanente Northern California Rehabilitation Services Education, Oakland, California and Assistant Professor, Department of Physical Therapy, School of Health Sciences, University of the Pacific, Stockton, California. She is also a licensed physical therapist in the state of California.

Recommended Citation

Hung E, Juha G, Davenport TE, Williams J. Physical Therapy Management of Myasthenia Gravis: A Case Study. The Internet Journal of Allied Health Sciences and Practice. 2024 Oct 04;22(4), Article 6.