15/04/2026
đ¨ āĻļāϰā§āϰ āĻĻā§āϰā§āĻŦāϞ āϞāĻžāĻāĻā§? āĻāĻāĻž āĻļā§āϧ⧠āĻā§āϞāĻžāύā§āϤāĻŋ āύāĻžāĻ āĻšāϤ⧠āĻĒāĻžāϰā§! đ¨ āĻā§āϞāĻžāύā§āϤāĻŋ āύāĻž āϰā§āĻ? āĻāĻžāύā§āύ Myasthenia Gravis āϏāĻŽā§āĻĒāϰā§āĻā§
đ§ MG āĻāĻāĻāĻŋ āĻĻā§āϰā§āĻāĻŽā§āϝāĻŧāĻžāĻĻā§ autoimmune neuromuscular disorder, āϝā§āĻāĻžāύ⧠āĻĒā§āĻļāĻŋ āϧā§āϰ⧠āϧā§āϰ⧠āĻĻā§āϰā§āĻŦāϞ āĻšāϝāĻŧā§ āϝāĻžāϝāĻŧ āĻāĻŦāĻ āĻā§āĻŦ āϏāĻšāĻā§āĻ āĻā§āϞāĻžāύā§āϤ āĻšāϝāĻŧā§ āĻĒāĻĄāĻŧā§āĨ¤
đ āĻā§āϰā§āϤā§āĻŦāĻĒā§āϰā§āĻŖ āĻŦāĻŋāώāϝāĻŧ: āĻŦāĻŋāĻļā§āϰāĻžāĻŽ āύāĻŋāϞ⧠āĻāĻŋāĻā§āĻāĻž āĻāύā§āύāϤāĻŋ āĻšāϝāĻŧ: āĻāĻāĻŋ MG-āĻāϰ āĻāĻāĻāĻŋ āĻĒā§āϰāϧāĻžāύ āĻŦā§āĻļāĻŋāώā§āĻā§āϝāĨ¤
đ āĻā§āύ āĻšāϝāĻŧ? (Causes)
āĻļāϰā§āϰ āύāĻŋāĻā§āĻ acetylcholine receptor (AChR)-āĻāϰ āĻŦāĻŋāϰā§āĻĻā§āϧ⧠antibody āϤā§āϰāĻŋ āĻāϰā§
âĄī¸ nerve â muscle signal āĻŦā§āϞāĻ āĻšāϝāĻŧā§ āϝāĻžāϝāĻŧ
âĄī¸ āĻĢāϞ⧠muscle contraction āĻĻā§āϰā§āĻŦāϞ āĻšāϝāĻŧ
đ§Š āĻā§āĻāĻāĻŋāϰ āĻāĻžāϰāĻŖ:
â Thymus gland āϏāĻŽāϏā§āϝāĻž (Thymoma / Hyperplasia)
â Autoimmune disease (Thyroid, Rheumatoid arthritis)
â Infection, stress, surgery
â āĻāĻŋāĻā§ āĻāώā§āϧ
đĒ āϞāĻā§āώāĻŖ (Symptoms)
đī¸ āĻā§āĻāϰ āĻĒāĻžāϤāĻž āĻĒāĻĄāĻŧā§ āϝāĻžāĻāϝāĻŧāĻž (Ptosis), āĻĄāĻžāĻŦāϞ āĻĻā§āĻāĻž (Diplopia)
đŖī¸ āĻāĻĨāĻž āĻŦāϞāĻž āĻŦāĻž āĻāĻŋāϞāϤ⧠āϏāĻŽāϏā§āϝāĻž
đĻĩ āĻšāĻžāϤ-āĻĒāĻžāϝāĻŧā§ āĻĻā§āϰā§āĻŦāϞāϤāĻž (āĻŦāĻŋāĻļā§āώ āĻāϰ⧠proximal muscle)
đĢ āĻļā§āĻŦāĻžāϏāĻāώā§āĻ
đ āĻāĻžāĻ āĻāϰāϞ⧠weakness āĻŦāĻžāĻĄāĻŧā§, āĻŦāĻŋāĻļā§āϰāĻžāĻŽā§ āĻāĻŽā§ āĻāĻāĻž MG-āĻāϰ classic sign
đ¨ āĻāϰā§āϰāĻŋ āĻ
āĻŦāϏā§āĻĨāĻž: Myasthenic Crisis
đ āĻšāĻ āĻžā§ āĻļā§āĻŦāĻžāϏ āύāĻŋāϤ⧠āĻāώā§āĻ āĻšāϞā§
đ āĻāĻāĻŋ life-threatening : āĻĻā§āϰā§āϤ āĻšāĻžāϏāĻĒāĻžāϤāĻžāϞ⧠āύāĻŋāϤ⧠āĻšāĻŦā§
đââī¸ āĻĢāĻŋāĻāĻŋāĻāĻĨā§āϰāĻžāĻĒāĻŋ āĻāĻŋāĻāĻŋā§āϏāĻž (Rehabilitation)
đ¯ āϞāĻā§āώā§āϝ:
â āĻĒā§āĻļāĻŋāϰ āĻļāĻā§āϤāĻŋ āĻŦāĻžāĻĄāĻŧāĻžāύā§
â āĻā§āϞāĻžāύā§āϤāĻŋ āύāĻŋāϝāĻŧāύā§āϤā§āϰāĻŖ
â āĻĻā§āύāύā§āĻĻāĻŋāύ āĻāĻžāĻ āϏāĻšāĻ āĻāϰāĻž
â āĻļā§āĻŦāĻžāϏāĻĒā§āϰāĻļā§āĻŦāĻžāϏ āĻ āĻŋāĻ āϰāĻžāĻāĻž
đ§ Exercise Guidelines
đš Energy Conservation (āϏāĻŦāĻā§āϝāĻŧā§ āĻā§āϰā§āϤā§āĻŦāĻĒā§āϰā§āĻŖ)
â āĻāĻžāĻā§āϰ āĻŽāĻžāĻā§ āĻŦāĻŋāĻļā§āϰāĻžāĻŽ āύāĻŋāύ
â āϏāĻāĻžāϞ⧠exercise āĻāϰā§āύ
đš Gentle Strengthening
â āĻšāĻžāϞāĻāĻž resistance (TheraBand / light weight)
â 8-10 āĻŦāĻžāϰ, fatigue āĻšāĻāϝāĻŧāĻžāϰ āĻāĻā§ stop
đš ROM Exercise
â āĻāϝāĻŧā§āύā§āĻ āĻļāĻā§āϤ āĻšāĻāϝāĻŧāĻž āĻĒā§āϰāϤāĻŋāϰā§āϧ
â āĻĒā§āϰāϤāĻŋāĻĻāĻŋāύ practice
đš Breathing Exercise
â Diaphragmatic breathing
â Incentive spirometry (āĻĒā§āϰāϝāĻŧā§āĻāύā§)
đš Functional Training
â Sit-to-stand, gait training
â ADL modification
â ī¸ āϏāϤāϰā§āĻāϤāĻž (Precautions)
â āĻŦā§āĻļāĻŋ āĻĒāϰāĻŋāĻļā§āϰāĻŽ āύāϝāĻŧ
â High intensity exercise āύāϝāĻŧ
â āĻāϰāĻŽ āĻĒāϰāĻŋāĻŦā§āĻļ āĻāĻĄāĻŧāĻŋāϝāĻŧā§ āĻāϞā§āύ
â
āĻļā§āĻŦāĻžāϏāĻāώā§āĻ āĻšāϞ⧠āϏāĻžāĻĨā§ āϏāĻžāĻĨā§ āĻŦā§āϝāĻŦāϏā§āĻĨāĻž āύāĻŋāύ
đ āĻāĻŋāĻāĻŋā§āϏāĻž (Medical Support)
â Pyridostigmine
â Immunosuppressants
â Thymectomy (āĻĒā§āϰāϝāĻŧā§āĻāύā§)
đ Clinical Tip:
đ âExercise āĻĻāϰāĻāĻžāϰ, āĻāĻŋāύā§āϤ⧠over āĻāϰāϞ⧠āĻā§āώāϤāĻŋâ
đ Sources:
* National Institute of Neurological Disorders and Stroke (2023) Myasthenia Gravis Fact Sheet. Available at: https://www.ninds.nih.gov/health-information/disorders/myasthenia-gravis (Accessed: 14 April 2026).
Mayo Clinic (2024) Myasthenia Gravis. Available at: https://www.mayoclinic.org/diseases-conditions/myasthenia-gravis (Accessed: 14 April 2026).
* National Health Service (2023) Myasthenia Gravis. Available at: https://www.nhs.uk/conditions/myasthenia-gravis/ (Accessed: 14 April 2026).
* Gilhus, N.E. (2016) âMyasthenia gravisâ, New England Journal of Medicine, 375(26), pp. 2570â2581. doi:10.1056/NEJMra1602678.
* Sanders, D.B., Wolfe, G.I., Benatar, M. et al. (2016) âInternational consensus guidance for management of myasthenia gravisâ, Neurology, 87(4), pp. 419â425. doi:10.1212/WNL.0000000000002790.
* Elsais, A., Moslemi, A.R. and Gilhus, N.E. (2020) âExercise training and physical activity in myasthenia gravis: a systematic reviewâ, Frontiers in Neurology, 11, p. 675. doi:10.3389/fneur.2020.00675.
* Myasthenia Gravis Foundation of America (2022) Myasthenia Gravis Overview. Available at: https://myasthenia.org (Accessed: 14 April 2026).
đŦ āĻļā§āϝāĻŧāĻžāϰ āĻāϰā§āύ please