Evaluation de l'efficacité d'un programme complet de thérapie de réadaptation chez des patients sous thymectomie pour MG

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Pboulanger
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Evaluation de l'efficacité d'un programme complet de thérapie de réadaptation chez des patients sous thymectomie pour MG

Message par Pboulanger » 25 janv. 2017 09:45

:hi:

Lu sur https://www.ncbi.nlm.nih.gov/pubmed/28099277
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Benefits of Comprehensive Rehabilitation Therapy in Thymectomy for Myasthenia Gravis: A Propensity Score Matching Analysis
Ambrogi V1, Mineo TC.
Am J Phys Med Rehabil. 2017 Feb;96(2):77-83. doi: 10.1097/PHM.0000000000000538.


Abstract

  • 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.
Amicalement,
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