Supervised, individualised exercise reduces fatigue and improves strength and quality of life more than unsupervised home exercise in people with chronic Guillain-Barré syndrome: a randomised trial

In people in the chronic phase of Guillain-Barré syndrome (GBS), how much more does a supervised, individualised exercise program improve functional independence with activities of daily living than a home-based exercise program? How do the two exercise programs compare regarding their effects on muscle strength, fatigue, pain and quality of life? Randomised controlled trial with concealed allocation, intention-to-treat analysis and blinding of outcome assessors. Sixteen adults with stable residual disability ≥ 6 months after the onset of GBS. Participants in the experimental group were allocated to 60-minute sessions of physiotherapist-supervised strengthening, endurance and breathing exercises, gait training and pain management, two to three sessions/week for 12 weeks. The control group was prescribed a home program of 30-minute sessions of maintenance exercises and education in self-management, two to three sessions/week for 12 weeks. Functional independence in activities of daily living on the 100-point Barthel Index (primary outcome), muscle strength on the 60-point Medical Research Council scale, fatigue on the 0-to-63 Fatigue Severity Scale, a visual analogue scale of pain severity, and quality of life, measured at baseline and months 6 and 12. At month 6, the median between-group difference was 5 (95% CI 0 to 20) for functional independence, 8 (95% CI 4 to 18) for strength, –13 (95% CI –28 to –1) for fatigue, and 12 (95% CI 3 to 13) for the environment domain of quality of life. Estimated effects at month 12 had a similar magnitude, but most of the CIs had greater uncertainty. Supervised, individualised exercise reduced fatigue and improved strength and quality of life more than unsupervised home exercise in people with chronic Guillain-Barré syndrome. CTRI/2016/08/007150.