{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T20:42:03Z","timestamp":1789591323566,"version":"build-2803163510"},"reference-count":34,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2018,6,4]],"date-time":"2018-06-04T00:00:00Z","timestamp":1528070400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neuromuscular Diseases"],"published-print":{"date-parts":[[2018,8,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Fatigue in myasthenia gravis (MG) is common and difficult to manage. Unlike myasthenic weakness it is not amenable to drug therapies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Our primary aim was to investigate whether a combination of physical and psychological therapy would help address symptoms of fatigue in MG patients, who have stable disease but residual problematic fatigue. Our secondary aim was to quantitate fatigue by applying different scores and to ascertain which would be most relevant to apply in MG.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We recruited 10 MG patients with stable disease and who suffer from fatigue. Nine of these 10 patients participated in a 10-week program that involved physical and psychological intervention. We quantified their fatigue using the modified fatigue impact scale (MFIS), the visual analogue fatigue scale (VAFS) and the fatigue severity scale (FSS) at the start of the study, at various intervals during the program and 3 months later.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During the program, there was a small improvement in the physical and psychosocial subscale of the MFIS. There was a significant improvement ( p &lt; 0.01) in the VAFS at the end of the program. No clear improvement was noted in FSS. Three months later, all fatigue scores declined to baseline but 50% of patients had made some life-style changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This is a small pilot study, which utilized a combined approach with physical and psychological therapy, and showed some benefit in improving fatigue in patients with MG. The improvement was small and unsustained. Because of the small patient cohort, one cannot derive any firm conclusions and a larger study is required to investigate this further.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3233\/jnd-170299","type":"journal-article","created":{"date-parts":[[2018,6,5]],"date-time":"2018-06-05T14:36:51Z","timestamp":1528209411000},"page":"373-385","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":34,"title":["A Physical and Psychological Approach to Managing Fatigue in Myasthenia           Gravis: A Pilot Study"],"prefix":"10.1177","volume":"5","author":[{"given":"Maria E.","family":"Farrugia","sequence":"first","affiliation":[{"name":"Department of Neurology, Institute of Neurological Sciences,\r            Queen Elizabeth University Hospital, Glasgow,\r            UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Di Marco","sequence":"additional","affiliation":[{"name":"Neuromuscular Physiotherapy, Clinical Genetics, West of\r          Scotland Genetic Services, Queen Elizabeth University Hospital,\r          Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denyse","family":"Kersel","sequence":"additional","affiliation":[{"name":"Department of Clinical Psychology, Institute of Neurological\r          Sciences, Queen Elizabeth University Hospital, Glasgow,\r            UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Carmichael","sequence":"additional","affiliation":[{"name":"Department of Neurology, Institute of Neurological Sciences,\r            Queen Elizabeth University Hospital, Glasgow,\r            UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,6,4]]},"reference":[{"key":"ref001","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31827f07be"},{"key":"ref002","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2377-13-132"},{"key":"ref003","doi-asserted-by":"publisher","DOI":"10.1002\/brb3.653"},{"key":"ref004","doi-asserted-by":"publisher","DOI":"10.1002\/mus.25386"},{"key":"ref005","doi-asserted-by":"publisher","DOI":"10.1002\/mus.25540"},{"key":"ref006","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181dc1b1e"},{"key":"ref007","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.52.7.1487"},{"key":"ref008","doi-asserted-by":"publisher","DOI":"10.1002\/mus.21883"},{"key":"ref009","doi-asserted-by":"publisher","DOI":"10.1002\/mus.25198"},{"key":"ref010","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/18.Supplement_1.S79"},{"key":"ref011","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2013.05.023"},{"key":"ref012","volume":"2010","author":"Tseng Benjamin Y","year":"2010","journal-title":"Stroke Res Treat"},{"key":"ref013","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1983.tb09716.x"},{"key":"ref014","doi-asserted-by":"crossref","unstructured":"GodolphinW.             Shared Decision-Making Healthcare Quarterly2009;186\u201390.","DOI":"10.12927\/hcq.2009.20947"},{"key":"ref015","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2016.07.027"},{"key":"ref016","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.55.1.16"},{"key":"ref017","doi-asserted-by":"publisher","DOI":"10.1016\/j.annrmp.2006.04.015"},{"key":"ref018","author":"Tascilar NF","year":"2017","journal-title":"Acta Neurol Belg"},{"key":"ref019","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2017.08.3250"},{"key":"ref020","doi-asserted-by":"publisher","DOI":"10.1016\/j.cyto.2012.02.015"},{"key":"ref021","doi-asserted-by":"publisher","DOI":"10.1002\/mus.25552"},{"key":"ref022","doi-asserted-by":"publisher","DOI":"10.1002\/mus.23478"},{"issue":"1","key":"ref023","first-page":"43","volume":"155","author":"Baldanzi S","year":"2017","journal-title":"Arch Ital Biol"},{"key":"ref024","doi-asserted-by":"publisher","DOI":"10.1097\/PHM.0000000000000032"},{"key":"ref025","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2016.1212109"},{"key":"ref026","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-017-8483-2"},{"key":"ref027","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-015-0737-7"},{"key":"ref028","doi-asserted-by":"publisher","DOI":"10.2340\/16501977-2247"},{"key":"ref029","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-017-8497-9"},{"key":"ref030","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000004497"},{"key":"ref031","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001008"},{"key":"ref032","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1396008"},{"key":"ref033","doi-asserted-by":"publisher","DOI":"10.1002\/mus.25493"},{"key":"ref034","doi-asserted-by":"publisher","DOI":"10.1002\/mus.24054"}],"container-title":["Journal of Neuromuscular Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.3233\/JND-170299","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.3233\/JND-170299","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.3233\/JND-170299","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T23:53:31Z","timestamp":1777506811000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.3233\/JND-170299"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6,4]]},"references-count":34,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2018,8,2]]}},"alternative-id":["10.3233\/JND-170299"],"URL":"https:\/\/doi.org\/10.3233\/jnd-170299","relation":{},"ISSN":["2214-3599","2214-3602"],"issn-type":[{"value":"2214-3599","type":"print"},{"value":"2214-3602","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,6,4]]}}}