Myasthenia Gravis
Conditions
Keywords
myasthenia gravis, inspiratory muscle training, respiratory muscle strength, spirometery
Brief summary
The goal of this clinical trial is to determine whether inspiratory muscle training aids in the recovery of respiratory muscle strength and helps prevent further muscle weakness in patients with myasthenia gravis. The primary research questions are: Does inspiratory muscle training enhance respiratory muscle strength recovery? Does the intervention lead to improved lung volumes? Participants underwent daily inspiratory muscle training and aerobic exercise for six consecutive weeks.
Detailed description
Patients with myasthenia gravis who experience acute exacerbations requiring hospitalization often suffer a significant decline in muscle strength, followed by partial recovery after the acute phase. This randomized controlled trial aims to evaluate the potential of early inspiratory muscle training and aerobic exercise in promoting muscle strength recovery and preventing further weakness. The study will assess differences in lung function, respiratory muscle strength, and dyspnea levels following the intervention after patients are discharged from the hospital post-acute exacerbation.
Interventions
PROCEDUREInspiratory muscle training
Patients in the IMT group received the intervention using a threshold loading device set at a pressure range of 5-39 cmH₂O. They were instructed to perform six sets of five breaths, totaling 30 breaths, twice daily for six weeks. Additionally, the aerobic exercise regimen included upper limb exercises (raising arms without resistance), a lower limb stepping warm-up, and a walking routine consisting of 5 minutes of slow walking, 2 minutes of brisk walking, and another 5 minutes of slow walking, for a total of 30 minutes per day.
PROCEDUREControl Group
Subjects received routine care.
Sponsors
Chang Gung University of Science and Technology
Kaohsiung Chang Gung Memorial Hospital,Taiwan
Chang Gung University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Hospitalized due to a myasthenia gravis crisis * Cleared for discharge from the hospital * Capable of completing six weeks of home-based respiratory muscle and exercise training
Exclusion criteria
* Myasthenia Gravis Foundation of America (MGFA) classification I or V * Presence of concurrent heart, kidney, liver, or metabolic diseases, or malignant tumors * Ability to follow exercise instructions * New York Heart Association (NYHA) Class III/IV * Pulmonary disease (FEV1/FVC ratio < 0.7 and FEV1 < 50% predicted)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Maximum inspiratory pressure | Six weeks | Maximum inspiratory pressure was measured by instructing each subject to exert their maximum inspiratory force against a pressure gauge. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Forced expiratory volume at one second | Six weeks | The forced expiratory volume at one second was obtained, using spirometry, by having the patient take a deep breath and then exhale forcefully. The test results were based on three reproducible measurements. |
| Peak expiratory flow | Six weeks | The peak expiratory flow was measured using a respiratory mechanics monitor during three forceful expirations. |
| Dyspnea Severity Assessment | Six weeks | Dyspnea severity was assessed by a rating of perceived exertion, using the Borg Scale which ranged from 0 (no respiratory difficulty) to 10 (extreme respiratory difficulty), with higher scores indicating more severe breathing difficulty. |
| Forced Vital Capacity | Six weeks | Forced vital capacity was measured using spirometry. Patients were instructed to take a deep breath and then exhale forcefully. The results were based on the average of three reproducible measurements. |
| Six-minute walk test | Six weeks | Patients were instructed to walk as fast as possible, while pulse oxygen saturation levels, heart rate, and Borg scale scores were monitored and recorded before, during, and after the test. |
| Maximum expiratory pressure | Six weeks | Maximum expiratory pressure was measured by instructing each subject to exert their maximum expiratory force against a pressure gauge. |
Countries
Taiwan
Outcome results
None listed