Physiotherapy immediately after thymectomy in patients with myasthenia gravis. Two cases and review of the literature

Abstract

AIM: Myasthenia gravis (MG) is a rare autoimmune disease characterized by activation of autoantibodies against acetylcholine receptors: patients with MG typically experience muscle weakness and fatigue. The aims of the present study were 1) to describe immediate postoperative physiotherapeutic interventions in two MG patients who underwent thymectomy, and 2) to discuss postoperative rehabilitative issues in MG patients.

MATERIALS AND METHODS: This was a non-experimental study analyzing two subjects with MG who underwent thymectomy. Furthermore, to find evidence on postoperative rehabilitative intervention in MG patients undergoing thymectomy, four major databases were searched through August 2016.

RESULTS: All subjects were able to walk on postoperative day (POD) 1 and to climb at least one flight of stairs on POD 4. Pain was more intense on POD 1 than on PODs 2 and 4. Dyspnea was worse on POD 2 than on PODs 1 and 4. Regarding the literature review, 58 papers were identified. After removal of duplicates, 51 citations remained to be screened. After the full texts were read, one paper met the inclusion criteria and was included.

CONCLUSIONS: Our findings indicate that patients are willing to undergo immediate physiotherapeutic treatment in the ICU after thymectomy. It seems that physiotherapeutic intervention after thymectomy in MG-grade IIa middle-aged patients can be initiated immediately postoperatively in uncomplicated cases.