Effect of low-intensity aerobic cycling ergometer on disease severity and depression of patients with myasthenia gravis in 'Dr. Soetomo' General Hospital Surabaya

Background and objectives. Myasthenia gravis (MG) is a chronic autoimmune disease characterized by muscle weakness. Muscle weakness leads to impairment of daily activities and leads to psychiatric symptoms, including depression. The lack of exercise methods in MG patients is a problem in rehabilitation. This study evaluates the effect of an 8-week low-intensity aerobic exercise program on Myasthenia Gravis Composite (MGC) and Beck Depression Inventory (BDI) scores in MG patients. Materials and methods. This is a randomized controlled trial conducted from May to June 2023. Twenty subjects were randomly divided into treatment group and control group. The treatment group received low-intensity aerobic exercise with cycle ergometer 3 sessions per week for 8 weeks. Both groups were informed about lifestyle changes and effective breathing exercises. MGC and BDI scores were measured and compared before and after intervention. Results. In the treatment group, MGC and BDI scores was significantly decreased with strong effect size after 8 weeks (5.4 ± 2.32 to 2.4 ± 1.84, p = 0.001, Cohen’s D = 1.57; and 10.4 ± 2.88 to 5.9 ± 2.77, p = 0.001, Cohen’s D = 1.86). In the control group, MGC and BDI scores were not significantly different (5.4 ± 2.68 to 6.0 ± 2.49, p = 0.193, Cohen’s D = 0.44; and 10.4 ± 1.71 to 9.6 ± 1.65, p = 0.247, Cohen’s D = 0.39). The MGC score strongly correlated with the BDI score (r = 0.50). Conclusion. 8 weeks of low-intensity aerobic exercise with cycling ergometer reduces disease severity and depression severity in myasthenia gravis.