There is Hope Through ‘CONTACT’Myasthenia Gravis Society of Canada 1 June 2018 There is Hope...

Myasthenia Gravis Society of Canada

1 June 2018 www.MGCanada.org

There is Hope Through ‘CONTACT’ Printed in the interest of those

affected by Myasthenia Gravis

Quarterly News Volume 42 Issue II June 2018

June Is Myasthenia Gravis

Awareness Month! MG publicity to all Canadians will help save lives and speed up diagnosis and

treatment. See the MG summary article that will help you get the word out to

whomever you can.

It`s been a positive spring of MG Canada progress.

Lots of progress with significant memoriam donations.

Exercise is key for all MG patients and should be part of your MG Fitness goals – with a reality check of your safe limits.

June3, GTA MG Canada support meeting will include an exercise workshop led by our

Midland MG patient and Athlete Hall of Famer, Garry Morehouse. Maryland Veteran

studies show benefits for many levels of MG condition and only 7% of MG

patients doing anything before successful assessment and assertion exercise program

began. Continued on Page 2

“Could It Be MG?”

MG Canada Support Meeting

Sunday, June 3, 2018 6-8 pm

Speaker Dr. Felicia Assenza, Doctor of Naturopathy Plus Exercise Workshop

led by Garry Morehouse See Page 3 For details



Dr. Felicia Assenza is a naturopathic doctor

who recently started practicing at the

Rosedale Chiropractic Clinic in Hamilton,

Ontario.

Being diagnosed with Muscular

Dystrophy in 2009, her own health

challenges lead her to discover the

wonderful world of naturopathic medicine

and she hopes to share her knowledge and

experiences with others to help them on

their own health journeys.

Felicia grew up in Hamilton and

attended McMaster University, where

she completed an Honours Bachelor of

Science degree majoring in Biology &

Psychology/Neuroscience/Behaviour. She then went on to earn her Doctor of

Naturopathy degree at the Canadian College of Naturopathic Medicine in Toronto. In

her 4th year of post-graduate study, she completed a clinical internship at the Robert

Schad Naturopathic Clinic with a focus on pediatrics, as well as a global clinical

preceptorship under the guidance of a medical doctor in India.

Felicia also loves food and gardening and believes both are among the most

powerful medicines.

Dr. Felicia Assenza will be speaking

at the June 3rd MG Support Meeting.

Introducing Dr. Felicia Assenza

Naturopathic Doctor

Naturopathy has a role to play for MG patients in conjunction with traditional treatments.

Even though MG is a chronic condition with no known cure to

date, major headway has come in treatment and holism – if you`re mature and diligent enough to

handle it. Our June 3 GTA MG Canada Support meeting speaker

will share her experiences treating MD and MG patients.

Cap Cowan, President

Myasthenia Gravis Society of Canada Walking sticks helped to do a little sight-seeing

in Ottawa during the Tulip Festival.



Support Meeting for those living with Myasthenia Gravis,

caregivers, family, friends & interested others to meet.

Info at 905 642 2545 www.MGCanada.org


MG Support Meeting

Registration: 5:30—6 pm.

Sunday, June 3, 2018 6-8 pm

For this meeting, we request those members who are able, with last name

starting A-L bring a food item to share. Loblaws has

asked that any food served come from their store.

Loblaws Community Meeting

Room, Bayview Village Mall,

2877 Bayview Avenue, North

York, M2K 2S3.

(Meeting Room is located

upstairs, S/W corner of the

store, Elevator access.)

Public Transit Access,

subway access at Bayview Station on the

Sheppard Subway. Free Parking,

Bayview Village Mall.

Speaker Dr. Felicia Assenza

Doctor of Naturopathy

Exercise Workshop by Garry Morehouse to develop ideas

practical to your MG capability.

Plus!




c/o 247 Harold Avenue, Stouffville, Ontario, L4A 1C2 Phone 905 642 2545 www.MGCanada.org

Do you have an MG article of interest to “Contact”?

Please forward to [email protected]

Articles in the Myasthenia Gravis Society of Canada Newsletter

express the views of the author and are for information only, not

medical advice. Patients should consult with their

physicians for medical treatment.

MG Canada’s Newsletter “Contact” is published by

MG Patient

Garry Morehouse Voted Into “Midland Athlete Hall of Fame”

Hi, Everyone!

Helen Proctor and I were just apprised that we will be inducted in the Midland Sports Hall of Fame in the Builder category for the development and growth of Pickleball in the Midland Area. The ceremony will take place September 29th. Save the date to join us for the celebration of Pickleball as a recognized sport. This might be a first for the sport.

A special thank-you goes to Bev Greenwood for submitting the nomination. We are grateful for the 12 endorsement letters of support from community leaders, including the mayors of the four Municipalities and MP Bruce Stanton. Plus, we received 19 personal testimonials of support from players. Thank-you for these wonderful mes-sages.

Garry and Helen

Garry Morehouse will be at the June 3rd MG Support

Meeting, and will do an exercise workshop to develop

ideas practical to your MG capability. (Details on Page 3)



What is MG Fit?

MG Fit is Your First National

Fundraising Campaign & More

MG Fit intends to assist in the costs of improving awareness and support of MG patients, caregivers, health care professionals and MG researchers.

The MG Fit campaign fulfills the mission of MG Canada to promote the health of MG patients by providing access to information and support group programs; to advance MG education through seminars, literature and other multi-media communications; and to receive and maintain funds for qualified MG research, or researches for MG cure. See Donor Form. on page 6.

Moreover, MG Fit intends to be a sustainable platform for MG patients to achieve wholeness in view of the changed dynamics of their bodies, minds and spirits. Those living with MG eventually realize that they have a “new normal” which changes their capabilities. MG Fit promotes the acceptance of MG chronic realities which will allow patients to pursue stability through treatment, and attain growth through the determination to live within their “new normal.”. Thus, more than just an awareness and fundraising campaign, MG Fit gives patients a guideline vision of encouragement to achieve personal wellbeing to reach new levels of personal fulfillment and wholeness, given the realities of this chronic condition.

MG Canada, a registered charity, not-for-profit organization with Registered Charitable # 81155 1431 RR0001, estimates that about 30,000 Canadians may have MG, but many have never been diagnosed, or worse, have been misdiagnosed with other conditions which can become life-threatening if they suffocate due to severe weakness of the respiratory muscles.

June is MG Awareness Month! One idea to help is to do an MG Fit Steps pledge campaign. We designed it

realistically doable for MG patients. Go to our National MG Canada Website

www.MGCanada.org and click on Front Page above walking feet. It will take

you to our registry. Sign up there, or use the form here in the Newsletter on the

following page, for the MG Fit challenge and for others to join you. You can

get pledges and do a personal walk or group walk. Just submit your pledge

sheet(s) to MG Canada with individual pledge details.

Tax receipts for $10 or over.



Donor Form “I am $tepping Up for MG Fit!” Name:_____________________________________________________ Address:__________________________________________________

City____________________ Prov._______ P. C . ________________

Phone ____________________________________

Email: ____________________________________________________

I support MG Fit by donating: (Please select one

___1,000 steps = $10 ___2,000 steps = $20 ___5,000 steps = $50

___10,000 steps = $100 Silver ___50,000 steps = $500 Gold

___100,000 steps = $1,000 Platinum Over 100,000 steps = $ _____________Platinum Plus

Please indicate: ___Online donation ___Cheque donation

For online donations please go to

www.MGCanada.org & www.MGFit.org online donations will receive an automatic receipt

For cheque donations please write cheque and mail to:


247 Harold Avenue, Stouffville, On., L4A 1C1 Further information Email [email protected]

Or call 905 642 2545 or www.MGCanada.org/donate

Myasthenia Gravis Society of Canada is registered charity #81155 1431 RR0001. Tax Receipts for donations of $10 and over

are issued unless otherwise specified.



ONLINE: Myasthenia Gravis Support Canada On Facebook, you can connect with others affected by Myasthenia

Gravis through the Myasthenia Gravis Support Canada Facebook

page, another way to learn more through discussion, posting and

comments. Use this URL:

https://www.facebook.com/groups/1380379838949713/ and link text is

Myasthenia Gravis Support Canada.

BY PHONE: MG Peer Support Group. Whether you have

recently received the news that you have Myasthenia Gravis, or you have been

living with MG and want to share your experience, these members have offered

their support. Please feel free to contact them to discuss your experience.

Ages under 40

Tiina Elder, Mississauga. 905-565-5875

email: [email protected]

Jill Thomson, Calgary, AB. T2J 0V6 403-286-0056

Ages 41 – 60

Phillip Sanderson, Harriston, ON, N0G 1Z0. 519-338-3356

Ages Over 61

Florence Pye, Carleton Place, ON, K7C 1P8. 613-257-1847

Vikki LeDez, Sunderland, ON, L0C 1H0 705-357-0377

email: [email protected]

Fernanda Nascimento, St. Catherines, ON. 905-937-9762

Pat Griffiths, Ottawa, Ontario. 613-237-1649

MG Canada Peer Support Group.

I love gardens!

https://www.facebook.com/groups/1380379838949713/



Thank you for the support Myasthenia Gravis Society of Canada has received from

“Celebration of Life” gifts, memberships, donations & MG Fit pledges.

Proceeds are used for newsletters, internet, hosting support meetings and advancing education and to contributing to Myasthenia Gravis Research.

Donations can be mailed to Myasthenia Gravis Society of Canada,

247 Harold Avenue, Stouffville, Ontario, L4A 1C2. Or online at

www.MGCanada.org/donate 905 642 2545

Registered Charity#81155 1431 RR0001

Celebration of Life “In Memoriam” Gifts Received For:

Robert Donald Duffy

Sally Weisfeld Toronto Ontario

Elizabeth Strathdee Toronto Ontario

Minnie (Taft) Cohen

Marguerite Marie “Margie” Hatt Chester Basin Nova Scotia

Maureen Sheane Alberta

Barbara Lynne Smith Gravenhurst Ontario

Peter Wilfrid Nightingale Toronto Ontario

Joyce Bridge



“I’m Doing Fantastic”

My name is Linda Kelm, I’m 66. In 2002, I had noticed that my arms were

weak, I couldn’t lift them over my head, speech was slurring, and my eyes

drooped. I was terrified. What was happening to me?

On June 11, 2002, I got the myasthenia gravis diagnosis. How was I going to take

care of my family? Am I going to work again? Why me? Oh God, why me? My meds

and treatments have included 1-3 day IViG treatments, prednisone, Mestinon, and

Imuran. Now I’m on CellCept and 30mg Mestinon a day. At present, I’ve lost almost

all of the 200 pounds that I gained while on prednisone.

Now I’m doing fantastic! I have a terrific neurologist who listens to me, and we

work great together. I do 13 steps to my basement; I do my laundry, drive, grocery

shop, cook/clean. I plan/organize small fundraisers for my auxiliary. Since January,

I’ve crocheted six afghans for my family. I’m doing an exercise program locally,

spending two hours a day, three days a week here. I’m on the treadmill, or bike,

Nustep, elliptical, arm crank, then I’m in the

weight room. I work on weights, stretches, my

balance, and started some mat exercises. I work

with a personal trainer who helps me with everything.

He knows about the MG; we both push me to

my limits and beyond. He challenges me by

adding a new exercise, or adding more reps

to an old one, and I’m always asking for

something new. I’m having fun and loving

the results!

Previously published by the MG Society of Illinois.

Exercise Important to Linda

Magnesium & Vitamin D3 Better Together

Oftentimes, we focus on a single nutrient and how it impacts

our physiology. However, one study recently highlighted the

importance of remembering the synergy between nutrients.

Magnesium and vitamin D3, for example, are two such nutrients

who prove to be better off together than alone. In a recent review

published in the Journal of the American Osteopathic Association,

magnesium was found to assist in the activation of vitamin D3.



Continued on Page 11

The Myasthenia Gravis Association of British Columbia published

the following article to be given to your GP (General Practitioner)

or any health care professional you think might benefit from this information.

Myasthenia is an autoimmune disease whereby the nerve stimuli to voluntary muscles are blocked by antibodies. It can occur at any age and can be rapid or slow in its development. It affects more females in children and younger age groups and males in the older age groups and the overall diagnosed incidence is about 17/100,000 people – so it is not a common disease for a GP with a list size of up to 3,000 patients – yet, though not actually curable, it is a treatable condition and it can be dangerous to miss. There are various types of Myasthenia Gravis.

COMMON PRESENTING SYMPTOMS TO BE AWARE OF

Eyes: there may be double vision or a drooping of the eyelid caused by local muscle weakness. Oral & Respiration: Difficulty in swallowing and sometimes difficulty in speech with the voice being much weaker. These symptoms should be addressed immediately with an emergency admission as it may lead to choking and/or a myasthenic crisis. Limb weakness: The weakness tends to affect the proximal muscles of the limbs, such as the inability to lift the arms or legs making usual mobility difficult. The symptoms may be less obvious early in the day and may worsen at the end of the day or after exertion. Symptoms may also worsen in hot environments – including hot showers or sun bathing. Characteristically the limb muscles fatigue very quickly, especially when doing repetitive movements or exercises.

DIAGNOSIS. The first help in diagnosis is considering the disease as a possibility and becoming familiar with the variety of symptoms. Many presiding symptoms in older individuals are slow in developing and may be dismissed as just part of the aging process. The drooping eyelid is a common presentation and should be an alert for follow up. Double vision also should bring the disease to mind as well as the increase in muscle weakness. A rarer variant may be in the ocular form but may develop into general myasthenia gravis. Being immunosuppressed makes it unwise to receive live vaccines. Myasthenia for GP’s Applying an ice-cold pad over a drooping eyelid can show a short-term relief. The presence of acetylcholine receptor antibodies in the blood is diagnostic though unfortunately not all cases show that. An Electromyography (EMG) test is usually requested by a neurologist and this will show a characteristic falling of muscle activity, when subjected to repeated stimulation.

Could It Be MG? Promoting Awareness!

Myasthenia Gravis for GP’s



TREATMENT Due to the rareness of the disease and the initial difficulties in diagnosis, it is wise to refer the patient to a neurologist familiar with MG. The most important thing is to avoid a ‘myasthenia crisis’, in which case the patient has a very sudden and acute problem with breathing. This can come on very quickly for patients whose MG is not stable. Admission to hospital is necessary.

MEDICATION This is usually begun in the hospital under supervision and may include the administering of Pyridostigmine (Mestinon) which provides short-term symptom relief but also needs to be taken frequently. The aim of long-term treatment is to suppress the body’s production of acetylcholine antibodies. Most patients require a steroid to induce and maintain stability. In severe cases, IVIG or plasma exchange may be used though the improvement may be short lived. In some, second-line immunosuppressant drugs are added to reduce the steroid requirement and long- term steroid use side-affects.

CAUTIONS. Some common medications, including antibiotics, used for other concurrent illnesses, can exacerbate MG. Check the list of drugs cautioned or contraindicated.

VACCINATIONS Being immunosuppressed makes it unwise to receive live vaccines.

LIVING WITH MG Though the diagnosis may be difficult, once under control patients can live a reasonably normal live with normal life expectancy. The disease does affect individuals differently – so it is important to be aware of your activity level and schedule times to rest as well. (Printed with permission of the Myasthenia Gravis Association of British Columbia.)

Continued from Page 10 Myasthenia Gravis for GP’s

Sunday, June 3, 2018, Myasthenia Gravis Society of Canada

Support Meeting. Loblaws Community Meeting Room, Bayview Village Mall, 2877 Bayview Village Mall, North York, M2K 2S3. 6-8 p.m. Info 905 642 2545.

Myasthenia Gravis Manitoba Inc. is holding support meetings Thursday, September 20, 2018 and November 15, 2018 at 7:00 pm at St. Boniface Hospital, 409 Tache Avenue, Winnipeg, Basement South Entrance. Room AG001 & 2. Bring family and friends and share your experience with Myasthenia Gravis. Info 204 444 7802

The Myasthenia Gravis Association of BC hosts Support Group Meetings twice a year.. Contact Information email: Myasthenia [email protected] or call 604 451 5511 for 2018 dates.

MG Support Group Contacts



Exercise and Myasthenia Gravis: A Review of the

Literature to Promote Safety, Engagement, and

Functioning Julia Naumes1*, Charlene Hafer-Macko2 and Sarah Foidel1 1School of Occupational Therapy, Pacific University, USA 2Department of Neurology, Neuromuscular Division, University of Maryland School of Medicine, and Geriatric Research Education Clinical Center (GRECC), Baltimore Veteran’s Administration Medical Center, USA *Corresponding Author:

Julia Naumes School of Occupational Therapy Pacific University, Hillsboro OR 97123, USA Tel: 1-808-345-2091 E-mail: [email protected]

Received date: June 04, 2016; Accepted date: June 29, 2016; Published date: June 30, 2016 Citation: Naumes J, Hafer-Macko C, Foidel S (2016) Exercise and Myasthenia Gravis: A Review of the Literature to Promote Safety, Engagement and Functioning. Int J Neurorehabilitation 3:218. doi:10.4172/2376-0281.1000218 Copyright: © 2016 Naumes J, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Visit for more related articles at International Journal of Neurorehabilitation

Abstract Currently no exercise protocol exists to inform healthcare practitioners how to advise individuals with myasthenia gravis how to begin exercise after stabilization of symptoms, which exercises are most beneficial for improving functioning, or detailing how to progress difficulty of the exercises as improvements in physiological functioning are made. However, with improved strength and endurance, individuals with myasthenia gravis will have a more meaningful life and the ability to engage in activities that are important to them. This literature review demonstrates that with skilled supervision by a rehabilitation professional, exercise is safe for those with mild myasthenia gravis and that strength gains and improvements in physiological functioning are possible. This research supports that exercise may decrease fatigue, increase strength, and improve functional mobility in individuals with myasthenia gravis. Additional rehabilitation research needs to be conducted on the physiological effects of exercise on individuals with myasthenia gravis and which exercises have the most significant impact on

Continued on Page 13

A Scientific View of Exercise for

MG Patients—Part I

https://www.omicsonline.org/open-access/exercise-and-myasthenia-gravis-a-review-of-the-literature-to-promotesafety-engagement-and-functioning-2376-0281-1000218.php?aid=76088#A1

https://www.omicsonline.org/open-access/exercise-and-myasthenia-gravis-a-review-of-the-literature-to-promotesafety-engagement-and-functioning-2376-0281-1000218.php?aid=76088#corr



https://www.omicsonline.org/archive-international-journal-of-neurorehabilitation-open-access.php

https://www.omicsonline.org/open-access/cd4-profile-and-relationship-with-bacterial-isolates-from-the-blood-ofhiv1-patients-attending-art-clinic-at-a-tertiary-healthcare-.php?aid=77092

https://www.omicsonline.org/open-access/title-a-novel-pain-rehabilitation-technique-2329-9096-1000e114.php?aid=77301

https://www.omicsonline.org/scholarly/neuro-rehabilitation-journals-articles-ppts-list.php



Keywords Exercise protocol; Myasthenia gravis; Occupational therapy; Strength training; Physiological functioning; Neuromuscular disease; Safety; Exacerbation; Myasthenic crisis Exercise and Myasthenia Gravis: A Literature Review Myasthenia gravis (MG) is characterized by symptoms of weakness, fatigue, and muscle failure with sustained and repetitive activities. Many healthcare practitioners believe that exercise may be contraindicated for the MG population, for fear of exacerbating the condition. Limited studies have been conducted on the safety and effectiveness of exercise programs for individuals with MG. However, without exercise, physiological capabilities diminish and fatigue increases, further limiting ability to engage in meaningful occupations. Additionally, exercise is beneficial for overall health and is a healthy coping strategy to deal with stress. This paper analyzes the available research on exercise rehabilitation for the MG population.

Literature Review Background Myasthenia gravis is a rare autoimmune disorder characterized by skeletal muscle weakness and fatigue which has significant impact on quality of life (QOL) [1-4]. In MG, antibodies attack the acetylcholine receptors of the neuromuscular junction, preventing contraction of the skeletal muscle. There are two primary types of MG, ocular and generalized. Ocular is characterized by diplopia and ptosis. Generalized MG presents with fatigue and weakness in axial, bulbar and limb muscles, which impairs balance and strength, and results in an overall decline in functional abilities [3,5]. In addition, varying severity levels of MG also impact an individual’s QOL and social engagement.

Purpose There is a lack of evidence-based research on exercise rehabilitation for the MG population; therefore, many healthcare practitioners feel uncomfortable prescribing exercise rehabilitation. However, many individuals with MG report using physical activity as a tool to self manage fatigue, maintain their identity and cope with stress [6]. These individuals are left to manage these activities without professional guidance on which activities to engage in or how to progress the exercises. The purpose of this literature review is to detail the available research on how the MG population can safely exercise, maintain muscle mass and physical abilities, and engage in meaningful occupations.

Treatments Pharmaceutical strategies are not entirely specific to the structural/ chemical

autoimmune defect in MG [7]. Immunosuppressant medications to treat the neuromuscular junction dysfunction and destruction have serious side effects and widespread metabolic consequences, which contribute to medical co-morbidities and further decrease QOL [7]. These current generalized and focused immune-based therapies afford the best pharmaceutical treatment options for managing MG. Treatment options that focus on Continued on Page 14

Continued from Page 12: A Scientific View of Exercise for MG Patients

https://www.omicsonline.org/open-access/the-determinants-of-strength-training-in-rural-women-ages-2044-years-a-qualitative-study-2167-0420-1000312.php?aid=72367

https://www.omicsonline.org/open-access/myasthenia-gravis-and-its-comorbidities-2155-9562-1000317.php?aid=60274

https://www.omicsonline.org/open-access/myasthenia-gravis-and-its-comorbidities-2155-9562-1000317.php?aid=60274

https://www.omicsonline.org/open-access/exercise-and-myasthenia-gravis-a-review-of-the-literature-to-promotesafety-engagement-and-functioning-2376-0281-1000218.php?aid=76088

https://www.omicsonline.org/open-access/exercise-and-myasthenia-gravis-a-review-of-the-literature-to-promotesafety-engagement-and-functioning-2376-0281-1000218.php?aid=76088

https://www.omicsonline.org/open-access/exercise-and-myasthenia-gravis-a-review-of-the-literature-to-promotesafety-engagement-and-functioning-2376-0281-1000218.php?aid=76088#1


https://www.omicsonline.org/scholarly/neurointensive-care-journals-articles-ppts-list.php



https://www.omicsonline.org/hiv-current-research.php






symptom management are either nonexistent or only address the immune system as a whole. This leaves many individuals with MG to self manage their symptoms [6].

Exercise fatigue in MG A significant concern in the MG population is the immediate and delayed fatigue as a result of excessive exercise. In a survey of MG fatigue, two thirds of respondents indicate that fatigue limits participation in activities, even with well-controlled disease severity [6]. Twenty percent of these respondents report engaging in low impact aerobic exercise, such as swimming and walking. These individuals self-reporting exercise participation have the highest levels of function and two-thirds use low intensity exercise to manage fatigue, suggesting activity may be a tool to manage fatigue and improve QOL. In addition, self-care actions emerge from the survey as supplemental strategies to diminish fatigue and conserve energy. Mental interventions reduce perceptions of fatigue through cognitive control, distraction, diversion and stress reduction. Energy conservation, awareness of one’s physical l limits, engagement in relaxing occupations, and proper sleep and rest hygiene are beneficial. MG fatigue may worsen from lack of sleep, poor nutrition and stress. Measures to counter MG fatigue include rehabilitation to improve body mechanics to reduce potential for injury and for energy conservation and structured exercise prescriptions. These activity recommendations should be combined recommendations for health and well-being, and individualized for each person with MG to account for disease variability.

Exacerbation and Safety Many individuals with MG and their clinicians are afraid of exacerbating

symptoms by engaging in strenuous exercise. However, research demonstrates

that exercise in individuals with mild MG improves strength and endurance [8-10].

Only seven percent of individuals with generalized MG are involved in regular

physical activity [11]. Factors related to exercise that can worsen MG symptoms

include inadequate activity pacing, extreme temperatures and humidity, and high

intensity activities, such as running, inclines, stairs, or prolonged exercise [6,12].

The presentation and severity of MG can be variable day to day and across a day,

depending on environmental and personal factors, such as timing of medication,

stress, sleep, nutrition, and other obligations. These issues require a customized

exercise program to meet individuals’ fluctuating needs and safety requirements,

otherwise exacerbations may occur.

Leddy and Chutkow [13] detail the challenges faced by

people with MG who participate in organized athletics.

Factors include limited exercise tolerance with potential

inability to maintain an optimal level of performance,

greater predisposition to soft tissue and orthopedic injuries,

and medication side effects. The disease severity and physical

demands of the sport must be taken into account on a case-

by-case basis. Low aerobic and anaerobic intensity sports,

such as golf, bowling, cricket, and curling , should be

encouraged to enable individuals with MG resuming

exercise to succeed. Continued on Page 15




https://www.omicsonline.org/open-access/energy-balance-through-the-looking-glass-2161-0673-1000e149.php?aid=77023









Additionally, the importance of weight-bearing exercise is stressed as a preventative measure to counter steroid-induced osteoporosis and myopathy. Currently, there is not sufficient evidence to determine the risk and reward that exercise poses for moderate and severe MG. Rehabilitation specialists with an understanding of MG, medication side effects, functional independence, kinesiology, and therapeutic exercises can help advise prior to engaging in sports, weighing the pros and cons of engagement and devising a successful exercise progression plan to meet the individual’s needs and to prevent injury. The exercise prescription intensity and progression needs to account for the MG severity and the individual’s overall health [14,15].

The Literature A 16-session balance strategy exercise program improved functional ability and balance

in the MG population [5]. Subjects (n=6) trained once or twice a week on therapeutic

workstation exercises, e.g. heel-toe walking, sit to stand

A 16-session balance strategy exercise program improved functional ability and

balance in the MG population [5]. Subjects (n=6) trained once or twice a week on

therapeutic workstation exercises, e.g. heel-toe walking, sit to stand, and ball catching

and throwing. Training improved MG severity on the quantitative myasthenia gravis

(QMG), Timed Up and Go (TUG) (cognitive), and standing balance on foam with

eyes closed. Although this study had a small sample size and variable group

characteristics (age, MG severity, functional ability), it demonstrated the benefit of

this short balance strategy intervention on functional performance, attention, and

postural stability.

Lohi et al. [9] demonstrated that physical training is safe and can improve

maximal muscle force and endurance for individuals with mild MG. Individuals

with mild to moderate MG (n=11) participated in a ten-week strength-training

program, their contralateral extremities served as the within-subject control. The

program was modified since many participants could not complete the prescribed

number of repetitions or increased work load progression. Participants had no negative

effects from the strength-training. Although most participants experienced slight to

moderate muscular pain during initial testing, training eliminated this muscular pain

during post-testing. Training increased knee extension maximal voluntary muscle force

by 23% (p<0.05). Elbow extension strength gains were made, but were not significant

(p=0.06). This is the first prospective study to show that supervised strength-training is

safe and can improve leg strength in the MG population. In support of these benefits,

a case report of a six week strength-training and aerobic exercise in an individual with

MG demonstrated decreased self-rated fatigue, improved hip extensor and flexor

strength, and his ability to golf .

Note: To be continued in Fall Issue of “Contact” or visit related articles at International Journal of Neurorehabilitation


https://www.omicsonline.org/international-journal-of-neurorehabilitation.php






https://www.omicsonline.org/archive-international-journal-of-neurorehabilitation-open-access.php



New MG Canada Member & All-Star Athlete

Shawn Creelman has many challenges, including a

recent diagnosis of Myasthenia Gravis, but he is a

hockey enthusiast who recently won a gold medal at

the Canadian Blind Hockey Association National

Tournament. He also plays with the Ice Owls and

scored 8 goals and 21 assists in fifteen games. He

took up curling this year, and stays active in the

summer with badminton, ball hockey, and fitness

room workouts.

Originally from Nova Scotia, Shawn is a volunteer

at the Leslieville Farmers Market and Canadian

Council of the Blind.

Celebrate Summer “Summer afternoon — summer afternoon; to me those have always been the two most beautiful words in the English language.” James Joyce

“Summer’s lease hath all too short a date.” Shakespeare




Formerly known as Myasthenia Gravis Ontario (Chapter)

MEMBERSHIP APPLICATION

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MG Canada "Support" Facebook quotes to May 2018 IVIG yesterday and today ... knocked the wind out of my sails .. hopefully will feel better tomorrow. Apparently the Island Health Authority decided to change the company that provides the IVIG Product so all new Lot Numbers ... never good for me. Thank the good Lord we have such great nursing staff who help you through it. Hi everyone I'm looking for some input... my dad got his thymus gland removed Feb 26th and was doing really well... but this week his speaking has gone downhill again like bad. he's still on medication and it doesn't seem to be helping. the Dr seems to think it's Because he's tired but he's really trying to take it easy. has anyone else experienced this? any tips? advice? anything?? we are so confused and it's turning to major worry. thanks in advance Good morning! This is a market report on MG. But it looks very interesting on how the MG market has been segmented. It gives an overview of how the business side of the medical world views mg. From diagnosis, to treatment, to medication. I also find it interesting to know where we stand in the MG Global community and which pharma is invested in delivering MG medication... Although it isn't good news to see "Impressive growth" it may mean MG patients are getting diagnosed faster. (and a lot more who were never diagnosed before) Please have a read. Being informed and knowing who are stakeholders are is very important. https://www.medgadget.com/2018/04/impressive-growth-of-myasthenia-gravis-disease-market-7-5-cagr-expected-by-2023-exclusive-research-by-marketresearchfuture-com.html I was only diagnosed a few weeks ago by EMG wire and am awaiting a ct scan of my thymus August 27th. A long time to wait. I am on nothing right now. I am having a difficult time walking with very poor balance and covering one eye no longer helps.

c/o 247 Harold Ave., Stouffville, Ontario, L4A 1C2

https://www.medgadget.com/2018/04/impressive-growth-of-myasthenia-gravis-disease-market-7-5-cagr-expected-by-2023-exclusive-research-by-marketresearchfuture-com.html



There is Hope Through ‘CONTACT’Myasthenia Gravis Society of Canada 1 June 2018 There is Hope...

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