Benefits and Tolerance of Exercise in Patients With Generalized and Stabilized Myasthenia Gravis
Benefits and Tolerance of Exercise in Patients With Generalized and Stabilized Myasthenia Gravis
The purpose of this study is to demonstrate that a 3 months physical exercise programme
 improves the Quality of Life of patients with generalized Myasthenia Gravis (MG) stabilized
 since at least 6 months under prednisone and/or azathioprine.
Three centers randomized simple blind clinical trial whose objective is to assess the
 efficacy on QoL improvement, and the tolerance of physical exercise over a period of 3 months
 in patients with generalized MG who have been stabilized since at least 6 months.

 During the 3 months pre-inclusion phase, the characteristics of MG will be collected.
 Physical activity and performance will be assessed monthly.

 MGQOL15 will be assessed at inclusion.

 Patients will be randomized in either intervention arm or control arm.

 The intervention arm will consist of three sessions exercise per week during three months.
 The daily exercise will be performed on a rowing machine that will be adapted to the
 patient's own physical ability.

 Physical activity will be measured with the help of an actimeter.

 Once a month, MG evolution and tolerance to exercise will be assessed and MG treatment dose
 will be collected.

 Exercise will be interrupted in case of MG exacerbation.

 Quality of life and psychological status will be assessed at 3, 6 and 9 months.

 Plasma levels of pro and anti-inflammatory cytokines will be measured at 3, 6 and 9 months in
 order to assess the effects of exercise on immune response.

 Patients enrolled in the control arm will benefit from the same follow-up but will not have
 exercise.
Inclusion Criteria:

 1. Patient with generalized MG of stage II or III according to the MGFA classification,
 stabilized for at least 6 months. Criteria for MG are either

 -  positive dosage of ant-RACh or MuSK auto-antibodies;

 -  If absent, myasthenic symptoms decrement> 10% in EMNG and test the positive
 prostigmine

 2. Patient ≥ 18 and ≤ 70 years old

 3. Patient having an health insurance

 4. Informed written consent

 Exclusion Criteria:

 1. Patients under particular protection

 2. Enrolment in another biomedical research in the last 3 months;

 3. Patients for whom physical practice is contra-indicated because of :

 -  Unstable coronary Syndrome or myocardial infarction within the past 3 months

 -  Heart failure with systolic ejection fraction < 50 %

 -  Respiratory failure defined by a vital capacity (CV) < 70 %

 -  Stroke

 -  Other neuromuscular pathology

 -  Disabling Rheumatologic disease (> 80 % disability according to the Barthel
 scale)

 -  Chronic Pain or disabling orthopaedic conditions

 -  Hospitalization in the last 3 months for a serious medical or surgical condition

 -  Anemia (hematocrit < 30%)

 4. MGFA grade I, grade IV or V

 5. Severe cognitive impairment

 6. MGQOL-15 below 15/60