TRATAMENTO FISIOTERAPÊUTICO NA MIASTENIA GRAVIS: UMA REVISÃO SISTEMÁTICA

Abstract

Myasthenia gravis (MG), a neuromuscular disease of autoimmune origin, its most common form causes varying degrees of tiredness and muscle weakness, which preferentially affect the voluntary contraction muscles. Although there is no cure, MG can be well controlled with proper treatment. Objective: to verify the physical therapy treatments available for MG. Materials and methods: the PICO strategy: population, intervention, comparison, outcome, was used, investigating patients with MG (population), physical therapy treatment (intervention), conventional clinical treatment (comparison), evaluating functional capacity, quality of life and strength muscle (outcome). Two independent reviewers searched four databases (PubMed, LILACS, PEDro, SciELO) until August 2022. Study quality was determined using the PEDro scale. The initial search returned 234 articles. Of these, 22 were selected after reading the title and abstract for full text evaluation. In the end, 12 articles remained based on pre-established eligibility criteria. The qualitative analysis of the studies indicated that resistance training (RT) significantly increased quality of life and global muscle strength, resistance respiratory muscle training (RMT) increased respiratory muscle strength and respiratory capacity, while RT associated with training aerobic exercise (AT) improves the quality of life, functional capacity and strength of volunteers with MG. It was concluded that physiotherapeutic rehabilitation improves the respiratory, functional capacity and quality of life of people with MG. The strategy with multiple approaches, including TMR, TR and TA seems to be the best therapeutic strategy if the intensity is moderate. Patients who benefit most are those with mild to moderate grade MG (grade IIa and IIb). More studies are needed to increase the level of evidence for the findings.