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Exercise for Stable Myasthenia Gravis

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ClinicalTrials.gov Identifier: NCT01047761
Recruitment Status : Recruiting
First Posted : January 13, 2010
Last Update Posted : November 1, 2016
Sponsor:
Collaborator:
Information provided by (Responsible Party):

Study Description
Brief Summary:
Generalized fatigue in myasthenia gravis results in physical deconditioning that reduces fitness and increases risk of obesity, hypertension, elevated cholesterol and type 2 diabetes. This study will examine how active and fit are 30 individuals with chronic, generalized myasthenic subjects. This study will also determine whether a 3 month home exercise program with aerobic, resistive, and pulmonary training can improve physical activity, strength, fitness, lung function and reduce cardiovascular disease risk.

Condition or disease Intervention/treatment Phase
Myasthenia Gravis Other: Exercise Phase 1

Detailed Description:
Generalized fatigue in myasthenia gravis results in a sedentary lifestyle and profound physical deconditioning, leading to reduced fitness and increased risk of obesity, hypertension, dyslipidemia, and type 2 diabetes. This study will characterize the activity and fitness levels and cardiovascular disease risk profile in 30 chronic, generalized myasthenic subjects. Hypotheses are that a) subjects with myasthenia gravis are physically inactive with reduced fitness level and high incidence of obesity and poor cardiovascular disease risk profile, and b) a 3 month multi-modal home exercise program that includes aerobic, resistive, and pulmonary training components will improve physical activity, strength, fitness, dyspnea, body composition and reduce cardiovascular disease risk. Specific aims are to a) define the baseline physical activity and fitness levels and prevalence of insulin resistance and dyslipidemia in stable sedentary myasthenic subjects, b) determine whether a 3 month moderate intensity home exercise program is safe and feasible in deconditioned, stable myasthenic subjects and c) whether a 3 month comprehensive home exercise program can enhance fitness, strength, and lung function to improve physical activity and reduce cardiovascular disease risk.

Study Design

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 30 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Multi-modal Exercise Program for Chronic Stable Myasthenia Gravis
Study Start Date : January 2010
Estimated Primary Completion Date : December 2020
Estimated Study Completion Date : December 2020


Arms and Interventions

Arm Intervention/treatment
Experimental: exercise
Multimodal exercises that include walking, breathing exercises, dynamic balance, and core strengthening.
Other: Exercise

3 month exercise intervention, three days a week Progressive in duration - up to 1 hour daily; Progressive in intensity

Multi-modal exercise program includes a) aerobic - walking, b) resistive training with therabands and core exercises, and c) breathing exercises



Outcome Measures

Primary Outcome Measures :
  1. Cardiovascular Fitness, Economy of Gait, Physiologic Reserve [ Time Frame: Baseline and 3 months ]

Secondary Outcome Measures :
  1. Ambulatory function (6 minute walk, 5 day step activity and accelerometer data) [ Time Frame: Baseline and 3 month ]
  2. Muscle strength by dynamometer [ Time Frame: Baseline and 3 month ]
  3. Myasthenia Quality of Life Scale, SF-36, and Visual Analogue Fatigue Scale [ Time Frame: Baseline and 3 months ]
  4. Cardiovascular risk profile (fasting glucose, oral glucose tolerance test, HbA1c, lipids), smoking status, and body mass index [ Time Frame: Baseline and 3 months ]
  5. Body Composition by DEXA and CT of mid-thigh and hip [ Time Frame: Baseline and 3 months ]
  6. Quantitative MG Scale [ Time Frame: Baseline and 3 months ]
  7. Pulmonary function tests - FVC and maximal inspiratory and expiratory pressure [ Time Frame: Baseline and 3 months ]

Eligibility Criteria

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 70 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • stable generalized myasthenia gravis
  • adults age 18-70

Exclusion Criteria:

  • already performing regular exercise
  • unstable angina
  • recent (<3 month) myocardial infarction, stroke, hospitalization for major illness or major surgery
  • chronic pain or orthopedic condition restricting exercise
  • active cancer, excluding basal cell cancer
  • anemia (HCT <30)
  • pregnancy
  • myasthenia gravis exacerbation in past 3 months
Contacts and Locations

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01047761


Contacts
Contact: Charlene Hafer-Macko, MD 410-328-3100 cmacko@grecc.umaryland.edu

Locations
United States, Maryland
University of Maryland and Baltimore VA Medical Center Recruiting
Baltimore, Maryland, United States, 21201
Principal Investigator: Charlene Hafer-Macko, MD         
Sponsors and Collaborators
Baltimore VA Medical Center
University of Maryland
Investigators
Principal Investigator: Charlene E Hafer-Macko, MD Baltimore VA Medical Center
More Information

Additional Information:
Responsible Party: Charlene Elaine Hafer-Macko, Myasthenia Gravis and Exercise, Baltimore VA Medical Center
ClinicalTrials.gov Identifier: NCT01047761     History of Changes
Other Study ID Numbers: Myasthenia and Exercise
First Posted: January 13, 2010    Key Record Dates
Last Update Posted: November 1, 2016
Last Verified: October 2016
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided

Keywords provided by Charlene Elaine Hafer-Macko, Baltimore VA Medical Center:
Myasthenia Gravis
Exercise
Fitness
Body Composition
Physical Activity
Pulmonary Function
Balance

Additional relevant MeSH terms:
Muscle Weakness
Myasthenia Gravis
Muscular Diseases
Musculoskeletal Diseases
Neuromuscular Manifestations
Neurologic Manifestations
Nervous System Diseases
Pathologic Processes
Signs and Symptoms
Autoimmune Diseases of the Nervous System
Neuromuscular Junction Diseases
Neuromuscular Diseases
Autoimmune Diseases
Immune System Diseases