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February 2017 CME Article No. 3: Benefits of Comprehensive Rehabilitation in Thymectomy for Myasthenia Gravis: A Propensity Score Matching Analysis
Additional Information
Objective:
To demonstrate the effectiveness of a comprehensive program of rehabilitation therapy in patients undergoing thymectomy for Myasthenia Gravis (MG).

Design:
From 2005 to 2010, 46 consecutive patients affected by MG underwent a rehabilitation program both before and after thymectomy. We matched each patient with a “control patient” who underwent thymectomy within the period 1999 to 2004 with no preoperative rehabilitation, who had the closest propensity score matching.

Results:
All patients but 2 were able to complete the intended program. Eighteen patients (41%) experienced mild fatigue (>25 at MG quantitative score). Propensity score selected a group of 17 patients for the matching process. The group of patients who underwent the rehabilitation program showed significant preoperative improvement associated with a reduced operative risk, a decreased early postoperative morbidity, a lower rate of postoperative intensive care unit needed (12% vs 35%; P = 0.01) and a shorter hospital stay (3 vs 5 days; P = 0.04). After the expected perioperative decline, all major myasthenic outcomes demonstrated a significant faster recovery at 3 months. Complete stable remission did not reveal significant differences.

Conclusions:
Exercise is not necessarily a contraindication in MG, and rehabilitation can be safely performed before and after thymectomy, reducing operative risks and decreasing recovery time.

Learning Objectives:
  1. Appreciate the benefits of physical therapy in individuals with Myasthenia Gravis
  2. Describe the benefits of physical therapy on postoperative morbidity in Myasthenia Gravis patient who undergo thymectomy
  3. Incorporate appropriate rehabilitation into the treatment plan of patient with Myasthenia Gravis
Summary
Availability: Retired
Cost: Member: $0.00
Non-Member: $15.00
Resident Member: $0.00
Resident Non-Member: $15.00
Credit Offered:
No Credit Offered
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