Rhythmic Auditory Stimulation and Walking Speed in the 6-minute Walk Test
Rhythmic Auditory Stimulation and Walking Speed in the 6-minute Walk Test
The aim of this study is to investigate if rhythmic auditory stimulation can influence
 walking speed, during a 6MWT in patients with myasthenia gravis (MG).
Background

 1. The 6-minute walk test (6MWT) is widely used in the clinic to measure treatment efficacy
 and disease progression in patients with neuromuscular diseases and is found valid and
 reliable to measure decrease in walking speed.

 2. Rhythmic auditory stimulation has repeatedly been shown to improve gait parameters in
 individuals with neurologic impairment.

 The aim of this study is to investigate if rhythmic auditory stimulation can influence
 walking speed, during a 6MWT in patients with myasthenia gravis.

 Patients with MG are asked to complete two 6MWTs separated by minimum 30 minutes of rest.
 Before the 6MWTs patient is instructed to walk 60 m as fast as possible, and their steps per
 minute (SPM) is recorded. When completing the 6MWTs, one of the tests is accompanied by music
 (m6MWT) with a beat per minute (BPM) corresponding to patients' SPM. The order of the 6MWTs
 is randomly decided by pre-ordered sealed envelopes.
Inclusion Criteria:

 -  Able to provide signed informed consent.

 -  Able to read and understand Danish or English.

 -  Diagnosis of mild to moderate MG (Able to provide signed informed consent.

 -  Able to read and understand Danish or English.

 -  Diagnosed with generalized mild to moderate myasthenia gravis (I-IV on the
 Myasthenia Gravis Foundation of American Clinical Classification, MGFA).

 -  Documented history of acetylcholine receptor (AChR) or Muscle Specific Kinase
 (MuSK) antibody positive, or abnormal repetitive nerve stimulation testing
 (decrement > 10%) on electromyography (EMG) or abnormal single fiber EMG
 (conduction block or jitter) or based on their clinical history and symptom
 improvement with acetylcholinesterase inhibitors.

 -  Ability to walk > 60 meters in a 6MWT.

 Exclusion Criteria:

 MGFA grade V disease

 -  Other disorders that are not related to MG, or drugs, that interfere with muscle
 strength, walking ability, balance and fatigue (e.g. heart failure).

 -  Serious medical illness (e.g. uncontrolled insulin dependent diabetes mellitus,
 symptomatic coronary artery disease, and cancer).

 -  Dementia or pregnancy.

 -  Unspecified reasons judged by the investigator