Correlation between Fatigue and Ability to Perform Activities of Daily Living in Myasthenia Gravis Patients

Authors

  • Adesti Permanasari Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia https://orcid.org/0000-0001-5074-5746
  • Damayanti Tinduh Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia https://orcid.org/0000-0001-6604-8152
  • Indrayuni Lukitra Wardhani Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
  • Imam Subadi Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
  • Paulus Sugianto Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
  • Yudith Dian Prawitri Department of Neurology, Faculty of Medicine, University of Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2022.8231

Keywords:

Myasthenia gravis, Fatigue, Fatigue severity scale, Activity of daily living, Myasthenia gravis-activities of daily living

Abstract

BACKGROUND: Myasthenia Gravis (MG) is an autoimmune disease of the neuromuscular junction that has autoantibodies that can be found in most cases. Fatigue and skeletal muscle weakness are the pathognomonic symptoms of MG and can be severely disabling, interfering with a patient’s ability to pursue activities of daily living, limiting their work, family, and social lives.

AIM: This study aimed to analyze the correlation between fatigue and the ability to perform activity of daily living (ADL) among patients with MG.

METHOD: Fatigue severity scale (FSS) was used to measure the fatigue and MG-ADL scale was used to evaluate the patient’s ability to perform ADL. Rank-Spearman test was used to assess the correlation between fatigue and patient’s ability to perform daily activities.

RESULTS: Thirty-one patients (nine males and 22 females) with MG were included and classified into three subgroups of fatigue: Non-fatigue (FSS <4), borderline (4 < FSS < 5), and fatigue (FSS >5). There was a significant correlation between fatigue and the patient’s ability to perform ADL (p = 0.005; p = 0.488) with CI 95%.

CONCLUSION: Fatigue in patients with MG correlates with the ability to perform ADL.

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References

Sieb JP. Myasthenia gravis: An update for the clinician. Clin Exp Immunol. 2014;175(3):408-18. https://doi.org/10.1111/cei.12217 PMid:24117026 DOI: https://doi.org/10.1111/cei.12217

Gilhus NE, Tzartos S, Evoli A, Palace J, Burns TM, Verschuuren JJ. Myasthenia gravis. Nat Rev Dis Prim. 2019;5(1):30. https://doi.org/10.1038/s41572-019-0079-y PMid:31048702 DOI: https://doi.org/10.1038/s41572-019-0079-y

Sadri Y, Haghi-Ashtiani B, Zamani B, Akhundi FH. Study of demographic, clinical, laboratory and electromyographic symptoms in Myasthenia Gravis patients referred to the neurology clinic of Rasoul Akram hospital in 2015. J Med Life. 2015;8(3):218-21. PMid:28316694

Bhat S, Chokroverty S. Fatigue in neurologic disorders. Sleep Med Clin. 2013;8(2):191-212. DOI: https://doi.org/10.1016/j.jsmc.2013.02.006

Hoffmann S, Ramm J, Grittner U, Kohler S, Siedler J, Meisel A. Fatigue in myasthenia gravis: Risk factors and impact on quality of life. Brain Behav. 2016;6(10):e00538. https://doi.org/10.1002/brb3.538 PMid:27781147 DOI: https://doi.org/10.1002/brb3.538

Naumes J, Hafer-Macko C, Foidel S. Exercise and myasthenia gravis: A review of the literature to promote safety, engagement, and functioning. Int J Neurorehabilitation. 2016;3(218):2376. DOI: https://doi.org/10.4172/2376-0281.1000218

Farrugia ME, di Marco M, Kersel D, Carmichael C. A physical and psychological approach to managing fatigue in myasthenia gravis: A pilot study. J Neuromuscul Dis. 2018;5(3):373-85. https://doi.org/10.3233/JND-170299 PMid:29889078 DOI: https://doi.org/10.3233/JND-170299

National Health Services. Fatigue in Myasthenia Gravis. United Kingdom: National Health Services; 2018.

Ruiter AM, Verschuuren JJ, Tannemaat MR. Fatigue in patients with myasthenia gravis. A systematic review of the literature. Neuromuscul Disord. 2020;30(8):631-9. https://doi.org/10.1016/j.nmd.2020.06.010 PMid:32718868 DOI: https://doi.org/10.1016/j.nmd.2020.06.010

Burns TM, Conaway MR, Cutter GR, Sanders DB. Construction of an efficient evaluative instrument for myasthenia gravis: The MG composite. Muscle Nerve. 2008;38(6):1553-62. https://doi.org/10.1002/mus.21185 PMid:19016543 DOI: https://doi.org/10.1002/mus.21185

Burns TM, Conaway M, Sanders DB. The MG composite: A valid and reliable outcome measure for myasthenia gravis. Neurology. 2010;74(18):1434-40. https://doi.org/10.1212/WNL.0b013e3181dc1b1e PMid:20439845 DOI: https://doi.org/10.1212/WNL.0b013e3181dc1b1e

Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD. The fatigue severity scale: Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol. 1989;46(10):1121-3. https://doi.org/10.1001/archneur.1989.00520460115022 PMid:2803071 DOI: https://doi.org/10.1001/archneur.1989.00520460115022

Butarbutar DT, Sudira PG, Astuti, Setyaningsih I. Uji reliabiltas dan validitas fatigue severity scale versi bahasa indonesia pada dokter residen RSUP Dr. Sardjito Yogyakarta. In: Pekan Ilmiah Regional XXVI Perhimpunan Dokter Spesialis Saraf Indonesia, Yogyakarta; 2014.

Wolfe GI, Herbelin L, Nations SP, Foster B, Bryan WW, Barohn RJ. Myasthenia gravis activities of daily living profile. Neurology. 1999;52(7):1487-9. https://doi.org/10.1212/wnl.52.7.1487 PMid:10227640 DOI: https://doi.org/10.1212/WNL.52.7.1487

Muppidi S. Outcome measures in myasthenia gravis: Incorporation into clinical practice. J Clin Neuromuscul Dis. 2017;18(3):135-46. https://doi.org/10.1097/CND.0000000000000156 PMid:28221304 DOI: https://doi.org/10.1097/CND.0000000000000156

Muppidi S, Wolfe GI, Conaway M, Burns TM, Group Mgcandms. MG-ADL: stiLl a relevant outcome measure. Muscle Nerve. 2011;44(5):727-31. https://doi.org/10.1002/mus.22140 PMid:22006686 DOI: https://doi.org/10.1002/mus.22140

Fan L, Ma S, Yang Y, Yan Z, Li J, Li Z. Clinical differences of early and late-onset myasthenia gravis in 985 patients. Neurol Res. 2019;41(1):45-51. https://doi.org/10.1080/01616412.2018.1525121 PMid:30311866 DOI: https://doi.org/10.1080/01616412.2018.1525121

Melzer N, Ruck T, Fuhr P, Gold R, Hohlfeld R, Marx A, et al. Clinical features, pathogenesis, and treatment of myasthenia gravis: A supplement to the Guidelines of the German Neurological Society. J Neurol. 2016;263(8):1473-94. https://doi.org/10.1007/s00415-016-8045-z PMid:26886206 DOI: https://doi.org/10.1007/s00415-016-8045-z

Alshekhlee A, Miles JD, Katirji B, Preston DC, Kaminski HJ. Incidence and mortality rates of myasthenia gravis and myasthenic crisis in US hospitals. Neurology. 2009;72(18):1548-54. https://doi.org/10.1212/WNL.0b013e3181a41211 PMid:19414721 DOI: https://doi.org/10.1212/WNL.0b013e3181a41211

Berrih-Aknin S, Le Panse R. Myasthenia gravis: A comprehensive review of immune dysregulation and etiological mechanisms. J Autoimmun. 2014;52:90-100. https://doi.org/10.1016/j.jaut.2013.12.011 PMid:24389034 DOI: https://doi.org/10.1016/j.jaut.2013.12.011

Somers EC, Thomas SL, Smeeth L, Hall AJ. Are individuals with an autoimmune disease at higher risk of a second autoimmune disorder? Am J Epidemiol. 2009;169(6):749-55. https://doi.org/10.1093/aje/kwn408 PMid:19224981 DOI: https://doi.org/10.1093/aje/kwn408

Diaz BC, Flores-Gavilán P, García-Ramos G, Lorenzana- Mendoza NA. Myasthenia gravis and its comorbidities. J Neurol Neurophysiol. 2015;6(5):1-5.

Feasson L, Camdessanché JP, El Mhandi L, Calmels P, Millet GY. Fatigue and neuromuscular diseases. In: Annales de Réadaptation et de Médecine Physique. Amsterdam, Netherlands: Elsevier; 2006. p. 375-84. DOI: https://doi.org/10.1016/j.annrmp.2006.04.016

Westerberg E, Molin CJ, Lindblad I, Emtner M, Punga AR. Physical exercise in myasthenia gravis is safe and improves neuromuscular parameters and physical performance-based measures: A pilot study. Muscle Nerve. 2017;56(2):207-14. https://doi.org/10.1002/mus.25493 PMid:27935072 DOI: https://doi.org/10.1002/mus.25493

Chu HT, Tseng CC, Liang CS, Yeh TC, Hu LY, Yang AC, et al. Risk of depressive disorders following myasthenia gravis: A nationwide population-based retrospective cohort study. Front psychiatry. 2019;10:481. https://doi.org/10.3389/fpsyt.2019.00481 PMid:31354544 DOI: https://doi.org/10.3389/fpsyt.2019.00481

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Published

2022-01-19

How to Cite

1.
Permanasari A, Tinduh D, Wardhani IL, Subadi I, Sugianto P, Prawitri YD. Correlation between Fatigue and Ability to Perform Activities of Daily Living in Myasthenia Gravis Patients. Open Access Maced J Med Sci [Internet]. 2022 Jan. 19 [cited 2024 Mar. 28];10(B):205-9. Available from: https://oamjms.eu/index.php/mjms/article/view/8231

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