Influence of Exercise on Patients with Guillain-Barré Syndrome: A Systematic Review

Abstract

Purpose: To evaluate the effects of exercise interventions on improving physical outcomes in patients with Guillain-Barré syndrome (GBS). Methods: The PubMed database was searched for articles published up to and including February 2015. Randomized controlled trials (RCTs), case reports, and quasiexperimental and single-subject designs published in English-language, peer-reviewed journals that assessed the impact of physical exercise on patients with GBS were included; study quality was assessed using Sackett's rules of evidence. Data are presented qualitatively and quantitatively using numerical values and percentages. Results: Seven articles were included in the systematic review. One RCT showed that high-intensity relative to lower intensity exercise significantly reduced disability in patients with GBS, as measured with the FIM (p < 0.005, r ¼ 0.71). Overall, various types of exercise programmes improve physical outcomes such as functional mobility, cardiopulmonary function, isokinetic muscle strength, and work rate and reduce fatigue in patients with GBS. Conclusion: Because of insufficient high-quality literature, making confident conclusions about the effects of exercise interventions on physical outcomes in patients with GBS is not possible. Future research should consider using higher quality study designs to confirm the results outlined in this article.Key Words: exercise; Guillain-Barré syndrome; physical exertion; rehabilitation; systematic review. RÉ SUMÉObjectif : é valuer les effets des programmes d'exercice sur l'amé lioration des capacité s physiques des patients atteints du syndrome de Guillain-Barré (SGB). Mé thode : une recherche a é té effectué e dans la base de donné es PubMed sur les articles publié s jusqu'en fé vrier 2015. Des essais contrô lé s randomisé s (ECR), des é tudes de cas, des modè les quasi expé rimentaux et des é tudes individuelles publié s dans des revues anglophones ré visé es par les pairs qui é valuaient l'effet de l'exercice physique sur les patients atteints du SGB ont é té inclus ; la qualité des é tudes a é té é valué e à l'aide de la rè gle des preuves de Sackett. Les donné es ont é té pré senté es de maniè re qualitative et quantitative à l'aide de valeurs numé riques et de pourcentages. Ré sultats : sept articles ont é té inclus dans la revue systé matique. Un ECR a montré que l'exercice à haute intensité par rapport à l'exercice à faible intensité ré duisait de maniè re significative les incapacité s des patients atteints du SGB, mesuré es par la mesure d'indé pendance fonctionnelle (p < 0,005, r ¼ 0,71). Globalement, divers types de programmes d'exercice amé liorent les capacité s physiques, dont la mobilité fonctionnelle, la fonction cardiopulmonaire, la force musculaire isociné tique et le rythme de travail, et ré duisent la fatigue chez les patients atteints du SGB. Conclusion : en raison du manque d'é tudes de qualité , il n'est pas possible de tirer de conclusions dé finitives sur les effets des programmes d'exercice sur les capacité s physiques de...

Physical Therapy and Functional Motor Recovery in Patient with Guillain-Barré Syndrome - Case Report

“…The intensity was consistent with the functional capabilities of the cardiovascular system, which required a three-fold heart rate and arterial blood pressure measurement during the session performance, as well as the appearance of rapid fatigue in GBS patient (Arsenault, 2016…”

Psychiatric Sequelae of Guillain-Barré Syndrome: Towards a Multidisciplinary Team Approach

“…Garssen et al reported that physical exercise not only significantly reduces fatigue, but also relieves anxiety and depression [38]. The implementation of a tailor-made exercise programme reduces fatigue in GBS patients by 20% [4,38]. Although physical fitness itself reduces fatigue levels and improves mental functioning, exercise also improves fatigue independent of the patient's physical fitness level [29,38].…”

“…Conflicting reports have suggested that not all GBS patients have favourable responses to exercise [45,46]. A lack of improvement in residual fatigue may not be easy to rationalise, due to the absence of an underlying pathophysiological mechanism (such as nerve dysfunction, anaemia, hypothyroidism, diabetes, or chronic illness) [7,30].…”

“…The acute polyneuropathy manifests as bilateral symmetrical muscle paresis/paralysis (affecting balance, posture, joint mobility and gait), hyporeflexia/areflexia (usually affecting the calcaneal reflex), and sensory dysfunction (tingling and burning sensations) progressively ascending from the lower limbs. Occasionally, cranial nerve involvement causes unilateral facial palsy or facial diplegia [4]. The pathophysiology of GBS involves immune-mediated demyelination and/or axonal damage of peripheral nerves due to molecular mimicry between microbial antigens (e.g., Campylobacter jejuni, Mycoplasma pneumonia, cytomegalovirus, Epstein-Barr virus, influenza virus) and neuronal antigens.…”

Experience in the Use of Plasmapheresis in Acute Inflammatory Demyelinating Polyradiculoneuropathy Guillain – Barre Syndrome in the Patient With Chronic Hepatitis C Virus Infection and Type 2 Diabetes Mellitus

“…Различные типы упражнений позволяют улучшить физическое состояние пациента (увеличение мышечной силы, улучшение функций сердечно-легочной системы), а также снизить общую слабость и патологическую утомляемость [29]. Выбор вида реа-билитационного лечения зависит от выраженности неврологического дефицита, сопутствующей патологии и психического состояния пациента.…”