The Effect of Spinal Stabilization Exercises in Patients With Myasthenia Gravis
Condition: Myasthenia Gravis
MeSH terms: Myasthenia Gravis; Muscle Weakness
Study type: Interventional

Summary: 
      Myasthenia Gravis (MG) is an autoimmune disease characterized by increased exercise-induced
      fatigue and muscle weakness. MG is a disease caused by impaired receptor function due to
      antibodies to nicotinic acetylcholine receptors in postsynaptic region in voluntary skeletal
      muscles.Spinal stabilization exercises, which use the basic principles of motor learning,
      aiming to improve the coordination, contraction rate and endurance of the body muscles by
      increasing kinesthetic awareness, can be used to strengthen body stability.

      The aim of this study was to investigate the effects of spinal stabilization exercises on
      fatigue, muscle strength, pulmonary functions and functional capacity in patients with MG.
    

Detailed description: 
      Myasthenia Gravis (MG) is an autoimmune disease characterized by increased exercise-induced
      fatigue and muscle weakness. MG is a disease caused by impaired receptor function due to
      antibodies to nicotinic acetylcholine receptors in postsynaptic region in voluntary skeletal
      muscles. The disease usually begins with ptosis from ocular symptoms. With the progression of
      the disease, symptoms of bulbar muscles and extremity muscles are added to the ocular
      symptoms. Bulbar symptoms occur when speaking, swallowing, chewing difficulties and
      difficulty breathing, while the symptoms in the extremity muscles arise as the difficulty of
      raising the arms uphill and the strain of climbing stairs.

      The weakness of the limb muscles is proximal and distal in the arms and more proximal muscles
      in the legs. As the disease progresses, weakness occurs in most striated muscles. This causes
      weakness in the trunk muscles.

      In the literature, the physiotherapy methods used in MG patients include breathing exercises,
      aerobic exercises and resistant exercises.Spinal stabilization exercises enable activation of
      the trunk muscles.

      Spinal stabilization exercises, which use the basic principles of motor learning, aiming to
      improve the coordination, contraction rate and endurance of the body muscles by increasing
      kinesthetic awareness, can be used to strengthen body stability. Spinal stabilization
      exercises are a type of exercise that aims more smooth limb movements with a strong spine,
      ensuring smoothness and stability of the spine. In the literature, there is no study using
      spinal stabilization exercises in MG patients. The aim of this study was to investigate the
      effects of spinal stabilization exercises on fatigue, muscle strength, pulmonary functions
      and functional capacity in patients with MG.

      Method The study was planned as randomized, single-blind and cross-over. Randomization will
      be done with closed envelope system. Group 1 will be written on five sheets and group 2 will
      be written on another five sheets.

      Then, these papers will be placed on the envelopes, these envelopes will be mixed in a box
      and patients will be asked to withdraw from these envelopes.

      Thus, patients will be divided into 2 groups. Assessments will be made by Yeliz Salcı and
      Ebru Kütük Çalıkçı. The assessors will not know who is in the which group. Treatment
      intervention will be done by Ali Naim Ceren. The assessors will evaluate patients without
      knowing the patients' groups. So the work will be single blind. Group 1, 3 days per week for
      6 weeks so that it will be taken to the physiotherapy program consisting of spinal
      stabilization exercises. Also the treatment will be supported by home program exercises. The
      patients will be rested for 4 weeks to eliminate the effects of the spinal stabilization
      program. After this period, only the home program will be given for 6 weeks. In Group 2;
      treatment will start with a 6-week home program, followed by a 4-week break.

      At the end of this period to be 3 days a week for 6 weeks spinal stabilization exercise
      program will be implemented. In addition to this exercise program, patients will be given a
      home program. The home program will include breathing exercises tailored to the patient's
      needs, calisthenic exercises, and MAT activities.

      Assessments will be made at the beginning of the treatment, after 6 weeks of treatment, at
      the end of 4 weeks of rest and at the end of 6 weeks of treatment.
    

Intervention name(s): Spinal stabilization exercise
Intervention type(s): Other
Intervention description(s): The effects of spinal stabilization exercise in patients with myasthenia gravis will be investigated.There is no study in the literature that previously applied spinal stabilization exercises in patients with myasthenia gravis. The benefits of spinal stabilization exercises in other diseases are shown.
Other intervention name(s): home based program
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Single (Investigator)
Primary purpose: Treatment