Physical and respiratory training in patients with myasthenia gravis: a systematic review with meta-analysis

Myasthenia gravis is a chronic autoimmune disorder that affects the neuromuscular junction, leading to impaired muscle function. This systematic review aimed to evaluate the current scientific evidence on the effects of training programs on symptom severity, performance in activities of daily living, quality of life, physical fitness, and respiratory function in individuals with myasthenia gravis. A systematic review and meta-analysis were conducted following the PRISMA guidelines. Searches were performed in PubMed, Scopus, Web of Science, and CINAHL Complete databases. Outcomes of interest included symptom severity scores, quality of life, activities of daily living performance, physical fitness, and respiratory parameters. A total of 1564 records were identified. After removing duplicates and screening titles, abstracts, and full texts, 20 studies were included in the qualitative synthesis, with 10 of them contributing to quantitative meta-analyses. Training interventions were associated with reductions in symptoms, as well as improvements in quality of life and performance in activities of daily living. Additionally, enhancements were observed in muscle strength, distance covered, and respiratory parameters. Physical activity and respiratory training may offer multiple benefits for patients with myasthenia gravis. Nevertheless, individualized exercise programs are essential to ensure safety and optimize adherence among this population.