Outcomes of high- and low-intensity rehabilitation programme for persons in chronic phase after Guillain-Barré syndrome: A randomized controlled trial
Fary Khan, Julie F. Pallant, Bhasker Amatya, Louisa Ng, Alexandra Gorelik , Caroline Brand
Objective: To assess the effectiveness of a high- vs low-intensity multidisciplinary ambulatory rehabilitation programme over 12 months for persons in the chronic phase after Guillain-Barré syndrome (pwGBS) in an Australian community cohort.
Method: A total of 79 pwGBS, recruited from a tertiary hospital, were randomized to a treatment group (n = 40) for an individualized high-intensity programme, or a control group (n = 39) for a lower intensity programme. The primary outcome the Functional Independence Measure (FIM) motor subscale assessed “activity limitation”; while secondary measures for “participation” included: World Health Organization Quality of Life; Depression, Anxiety Stress Scale; and Perceived Impact Problem Profile (PIPP) scales. All outcome measures were assessed at baseline and at 12 months.
Results: Intention to treat analysis of data from 69 participants (treatment n = 35, control n = 34) showed reduced disability in the treatment group in post-treatment FIM domains (mobility, transfers, sphincter control and locomotion; all p < 0. 005) and PIPP scores (relationships; p = 0. 011), with moderate-to-small effect sizes (r = 0. 36–0. 23). The treatment group compared with control group showed significant improvement in function (FIM scores): 68% vs 32%.
Conclusion: Higher intensity rehabilitation compared with less intense intervention reduces disability in pwGBS in later stages of recovery. Further information on rehabilitation modalities and impact on quality of life is needed.
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