# Physical activity and its effects in myasthenia gravis: a patient-reported study on habits and impact

## TL;DR

People with myasthenia gravis report benefits from physical activity, but remain less active than recommended, with barriers like pain and motivation.

## Contribution

This study identifies barriers and benefits of physical activity in MG patients using patient-reported outcomes and clinical correlations.

## Key findings

- Most MG patients reported positive effects of physical activity on mood and well-being.
- Physical activity levels were lower than recommended and inversely correlated with disease severity scores.
- Motivational issues and muscle pain were the main barriers to physical activity in MG patients.

## Abstract

Physical activity and exercise have been classified as safe and effective in mild to moderate cases of myasthenia gravis (MG) across various studies. Subsequently, adequate physical activity is generally recommended. Nevertheless, individuals with MG remain less physically active than the general population, without a precise definition of the low-activity group so far.

In this prospective single-center study, individuals with MG completed a questionnaire assessing general mobility, weekly physical activity levels, and beliefs toward specific statements about physical exercise. These data were contextualized with clinical parameters and MG-specific scores.

Among 84 individuals (50% female), 73.8% reported general positive effects, and 77.4% noted improvements in mood and well-being due to physical activity. No significant differences in physical activity levels were found depending on sex, BMI or age. Weekly physical activity averaged 94.6 min (SD: 85.6), falling below current recommendations. Physical activity was inversely correlated with lower QMG (p = 0.019) and MG-ADL scores (p = 0.004). Despite the reported positive impact of physical activity on quality of life, no relevant connection was detected between physical activity and MG-QoL15 scores.

Barriers preventing individuals affected by MG from engaging in physical activity included muscle pain (35.4%) and motivational challenges (22%). Individuals with motivational problems were younger (mean age 55.5 vs. 66.6 years, p = 0.011) and more frequently reported depressive symptoms; no other significant differences were observed in gender or disease severity in this subgroup.

Individuals with MG perceive physical activity as beneficial to their physical well-being, mood, and overall quality of life. Those with less severe disease tend to be more active. However, barriers such as motivational issues and post-exercise pain must be addressed. Clinicians should aim to identify individuals with low activity levels, encourage engagement in physical activity, highlight its benefits, and alleviate patient concerns.

Study approval by the Ethics Committee of the University Medical Center Göttingen was granted (number 33/12/21). The study was retrospectively registered at the German Clinical Trial Registry (DRKS) under the study ID DRKS00033171 (Date of trial registration December 1st, 2023).

The online version contains supplementary material available at 10.1186/s12883-025-04590-x.