Myasthenia gravis (MG) causes muscle weakness that can sometimes interfere with the activities of daily living. Both occupational and physical therapy may help.

MG is an autoimmune disorder, which means your body’s immune system makes antibodies that attack healthy cells by mistake.

In MG, the healthy cells that sustain damage are receptors and proteins at the neuromuscular junction, where your nerves connect to your muscles. This damage can reduce neurotransmitter signals to your muscles, causing them to weaken and become easily fatigued.

MG symptoms improve with rest and are less noticeable in the morning. As the day progresses, you might feel increased fatigue as your stamina wanes.

Both occupational and physical therapists can offer strategies and support that may help offset the effects of MG.

An occupational therapist (OT) helps people with disabilities or health conditions establish and maintain their independence. They help by supporting the development of skills in areas such as daily living and workplace functioning.

To help with MG, an OT can:

  • teach you energy conservation strategies
  • make suggestions to modify your living environment in ways that increase your safety, well-being, and ease of daily living
  • provide training in the use of assistive devices or mobility aids

Energy conservation strategies can include using equipment such as shower seats or wheeled laundry hampers and services such as grocery delivery.

Physical therapists (PTs) specialize in movement and body mechanics. They help people with physical injuries or disabilities move more easily and with less pain.

A PT can help you by:

  • evaluating your muscular weakness and fatigability
  • assessing your functional mobility and endurance
  • teaching you exercises for balance, strength, and flexibility
  • training you to pace yourself for energy conservation
  • teaching you exercises to improve posture and breathing

PTs and OTs can work together to create a daily living plan customized to suit your needs.

They can also work with speech-language pathologists, who help with issues involving communication, eating, and swallowing.

Since MG reduces your energy, it’s important that your support team coordinates their efforts so you’re not overwhelmed, which can leave you feeling fatigued.

MG fatigue can reduce your activity level, leading to a loss of muscle strength and tissue. Exercise can help counteract this loss, but it’s important to guard against fatigue. This means paying close attention to how much you exercise and ensuring that you don’t push yourself too much.

It’s also a good idea to have another person present while you exercise to make sure that your exertion doesn’t lead to fatigue-related injury or a myasthenic crisis, which is a symptom exacerbation that can interfere with your ability to breathe.

You may want to consider the following types of exercise:

  • Walking: Choose a comfortable pace on a flat surface. Avoid traffic and extreme temperatures.
  • Using a stationary bike: You can manage fatigue by staying seated and limiting your speed, resistance, and ride duration.
  • Swimming: It’s important to always have someone with you, stay in water that’s shallow enough for you to stand to rest, and avoid extreme temperatures.
  • Weight training: Though people without MG often lift weights to the point of fatigue, it’s important that you avoid this. Instead, use light weights, perform limited repetitions, and stop before you’re tired.
  • Using a treadmill: Using the safety key and tether, as well as the handrails for support, makes treadmill use safer. It’s also vital that you strictly limit your speed, duration, and incline to ensure that you don’t overdo this exercise.
  • Doing balance exercises: Balance training can reduce your chance of falling, increase your bone density, and increase muscle mitochondria, leading to less fatigue.
  • Stretching: Regular stretching can improve muscle and joint health while reducing pain.
  • Breathing: Respiratory muscle training may lead to reduced fatigue, according to a 2020 study.

People with mild to moderate MG should aim for at least 150 minutes of exercise each week.

Exercise is best for people with well-managed MG. If you’re experiencing an MG exacerbation, it’s best to check with your doctor or PT before you exercise.

If you’re taking MG medication, you can ask your doctor about the peak time of your medication dose so that you can plan your exercise for when you’ll have more energy.

Results can vary between individuals.

The type of support you receive can also affect how much time will pass before you see results.

It may take a few weeks before you notice the benefits of exercise. However, an energy-conserving strategy, such as having groceries delivered, may have an immediate benefit.

MG is an autoimmune disorder that affects the places where your nerves connect to your muscles. One of the key effects of this condition is muscle weakness.

OTs can support you by teaching you energy-conserving strategies to make daily living easier. PTs can help you strengthen your muscles so they work more efficiently.

It’s important that all the members of your care team work together to ensure that you’re not overwhelmed by an excess of energy-draining therapies.