Benefits and Tolerance of Exercise in Patients With Generalized and Stabilized Myasthenia Gravis
- Conditions
- Myasthenia Gravis
- Interventions
- Behavioral: Physical exercise programme using a rowing machine
- Registration Number
- NCT02066519
- Lead Sponsor
- Assistance Publique - Hôpitaux de Paris
- Brief Summary
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.
- Detailed Description
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.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 45
-
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
-
Patient ≥ 18 and ≤ 70 years old
-
Patient having an health insurance
-
Informed written consent
-
Patients under particular protection
-
Enrolment in another biomedical research in the last 3 months;
-
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%)
-
MGFA grade I, grade IV or V
-
Severe cognitive impairment
-
MGQOL-15 below 15/60
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Physical exercise arm Physical exercise programme using a rowing machine Arm with physical exercise on rowing machine between M3 and M6
- Primary Outcome Measures
Name Time Method Change in the quality of life between M3 and M6 by MGQOL score M3 and M6
- Secondary Outcome Measures
Name Time Method Cumulative dose of steroids within the 3 months of the exercise programme 6 MONTHS Plasma levels of pro- and anti-inflammatory cytokines at 9 months M9 Muscular strength M3, M6 and M9 Muscular strength (before exercise period, after exercise period and 3 months after)
Frequency of MG exacerbations 6 MONTHS Muscular endurance M3, M6 and M9 muscular endurance (before exercise period, after exercise period and 3 months after)
Severity of MG exacerbations 6 MONTHS Psychological status (STAI, BECK, MINI et SEI scales) at 3, 6 and 9 months M3, M6 and M9 Muscular fatigability M3, M6 and M9 fatigability (before exercise period, after exercise period and 3 months after)
Frequency and severity of respiratory side-effects 6 MONTHS Frequency and severity of cardiovascular side-effects 6 MONTHS Doses of anticholinesterasic and steroids at 3, 6 and 9 months M3, M6 and M9
Trial Locations
- Locations (1)
ICU and medical surgery department, Raymond Poincaré Hospital
🇫🇷Garches, Hauts-de-Seine, France