Effects of Treatments Applied in Myasthenia Gravis on Gait: Review

Abstract

Myasthenia Gravis (MG) is an autoimmune disease in which neuromuscular transmission is blocked and neuromuscular junction physiology is affected. The main feature in MG is altered muscle weakness and fatigue of muscle groups that worsens with exercise and improves with rest. With the emergence of muscle weakness in the following periods, walking is affected in MG. This causes balance and walking problems. Most of the patients have complaints of falling and fear of falling. While applying MG treatment, myasthenic symptoms should be reduced and a stable clinical picture should be obtained in which the daily activities of the person are relieved. The aim of this study is to understand the effect of rehabilitation practices on gait in MG and to determine which exercises are effective. As a result, physiotherapy and rehabilitation approaches can provide solutions to patients' complaints, albeit symptomatically. Active resistance exercises, aerobic exercises, balance strategy training, endurance exercises, posture exercises, stretching exercises and active–passive range of motion exercises should be performed in an exercise program. In addition, rhythmic auditory stimulation and pre-surgical respiratory physiotherapy also have positive effects on walking.

Keywords

• Autoimmune
• balance
• gait
• myasthenia gravis

Myastenia Gravis’te Uygulanan Tedavilerin Yürümeye Etkisi: Derleme

Öz

Miyastenia Gravis (MG), nöromusküler iletimin bloke olduğu ve nöromusküler kavşak fizyolojisinin etkilendiği otoimmün bir hastalıktır. MG’de temel özellik, egzersizle kötüleşen ve dinlenme ile iyileşen kas gruplarının değişen kas güçsüzlüğü ve yorgunluğudur. İlerleyen dönemlerde kas zayıflıklarının ortaya çıkmasıyla MG’de yürüme etkilenmektedir. Bu durum denge ve yürüme problemlerine neden olur. Hastaların çoğunda düşme ve düşme korkusu şikâyetleri vardır. MG tedavisi uygulanırken miyastenik belirtileri azaltılıp kişinin günlük yaşam aktivitelerinin rahatladığı stabil klinik tablo elde edilmelidir. Bu çalışmanın amacı MG’de rehabilitasyon uygulamalarının yürümeye etkisinin anlaşılması ve hangi egzersizlerin etkili olduğunu belirlemektir. Sonuç olarak fizyoterapi ve rehabilitasyon yaklaşımları, hastaların şikayetlerine semptomatik de olsa çözüm getirebilir. Egzersiz programında aktif dirençli egzersizler, aerobik egzersizler, denge strateji eğitimleri, endurans egzersizleri, postür egzersizleri, germe egzersizleri ve aktif–pasif eklem hareket açıklığı egzersizleri yapılmalıdır. Ayrıca ritmik işitsel stimülasyonun ve cerrahi öncesi respiratuar fizyoterapinin de yürümeye olumlu etkileri vardır.

Anahtar Kelimeler

• Otoimmün
• denge
• yürüme
• miyastenia gravis

Kaynakça

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