Myasthenia gravis is a neuromuscular disease that disrupts communication between the nerves and muscles. It’s an autoimmune disorder that causes muscles to get weaker and tire more easily over time. This skeletal muscle exhaustion tends to get better with rest.

Studies show that repetitive movements and exercise can worsen muscle weakness in people with the condition. However, maintaining muscle strength is important to staying strong and independent. How can people with myasthenia gravis get the benefits of physical activity without making their condition worse?

The answer may be medically supervised exercise. Physical therapy (PT) and occupational therapy (OT) are safe ways to work out with a health professional who understands your condition. If you’re interested in giving it a try, here’s what you can expect during your sessions.

Physical Therapy vs. Occupational Therapy

PT and OT are similar, but not the same thing. Understanding the difference between them can help you find the right type of support for your needs. There are some key differences in their approaches and goals.

Both PT and OT provide a structured exercise program that you do with medical guidance. A qualified health professional will guide you through specific movements and monitor your progress. PT works on big muscle groups to improve your body’s overall movement, strength, and physical well-being. OT focuses on improving how you move through your activities of daily living, like getting dressed or driving.

Both physical and occupational therapists are trained to listen to your concerns and help with the problems that most impact your life. They should spend time talking with you to learn how they can help.

During your first appointment, your provider will assess your strength and mobility and discuss your goals and concerns. You may not even exercise during the appointment. They can also give you tips you can use outside of the sessions, including ways to modify your living space and stretches or exercises to do at home.

In addition to giving you specific movements to work on, your physical or occupational therapist may talk to you about assistive devices that can help make some tasks easier and reduce strain on your body. They may also offer nerve stimulation or massages during your sessions.

As with other health care providers, your physical or occupational therapist needs to coordinate with your neurology team to develop the best plan for you.

Does Physical or Occupational Therapy Help?

While everyone is different, there’s good evidence that supervised training offers many benefits for people with myasthenia gravis. Strength training improves functional ability and muscle force, and respiratory muscle training boosts lung capacity. Balance training helps lower the risk of dangerous falls.

Research suggests that people with myasthenia gravis can reduce their symptoms with medication, but they may still struggle when daily tasks become more difficult to do independently. This constant reminder of a worsening neuromuscular disease can take a toll on mental health. OT is an opportunity to face these challenges head-on with support and guidance.

Overall, rehabilitative training may improve the quality of life for people with myasthenia gravis. It may also reduce fatigue. PT and OT don’t seem to have any notable downsides.

Activity Considerations for Myasthenia Gravis

Ideally, you’ll find a physical or occupational therapist who is familiar with myasthenia gravis. But because it’s a rare condition, the providers in your area may not have worked with myasthenia gravis specifically. You can partner with your provider by discussing some issues related to your condition.

Some factors your provider should consider before planning your sessions include:

• Exercise intensity — High-intensity exercise isn’t recommended for people with myasthenia gravis. It can make muscle weakness worse.
• Medication — If you take pyridostigmine, try to schedule your sessions 1.5 to 2 hours after your dose, when the medication is most effective.
• Session timing — Muscle weakness is usually worse later in the day, so morning sessions may be best.

If you notice symptoms like ptosis (eyelid drooping) worsening during your sessions, you may be overdoing it. Always communicate with your physical or occupational therapist if your symptoms change or if you need to take a rest. They should be flexible with you if you share openly with them.

Next Steps To Get Started

Starting something new can feel like a bit of a risk. But taking the leap to try PT or OT can be an important step to feeling your best. Talk to your neurologist about adding PT or OT interventions to your current treatment plan. They can provide a referral for you and explain what to expect before adding this new treatment to your routine.

Physical and occupational therapists work in different settings. Some work in rehab centers, long-term care facilities, hospitals, sports medicine facilities, or private practices. If you’re more comfortable doing sessions at home, look for a provider through a home health agency.

For your sessions, dress like you’re working out at the gym. Wear comfortable clothing and a sturdy pair of sneakers. Also, bring your water bottle. Sometimes, PT takes place in a pool, so dress accordingly if you’re doing aquatic activities.

If you’re not sure what to wear or bring, call the front desk and ask the receptionist. Physical and occupational therapists are used to working with people who have many different health conditions. After your first appointment, you should feel more confident about what to expect.

You’ll also be expected to put in work between sessions, especially if you’re only seeing the provider once or twice a week. Doing your homework can help you make better progress in reaching your goals. The therapist is there to teach you and support you, but they can’t fix your problems alone. You also have to do your part for the program to be successful.

Although some people may choose to continue PT or OT for a while, the goal is typically to teach you the skills so you can “graduate” from the program. You’ll learn new ways to move and exercise on your own, so ongoing sessions won’t be necessary. Typically, people learn exercises they can do on their own as part of a home exercise program.

Talk With Others Who Understand

MGteam is the social network for people with myasthenia gravis and their loved ones. On MGteam, more than 2,000 members come together to ask questions, give advice, and share their stories with others who understand life with myasthenia gravis.

Have you worked with an occupational or physical therapist? If so, did you have any positive or negative side effects? Share your experience in the comments below, or start a conversation by posting on your Activities page.