Authors of a recently published systematic review say it provides "good" evidence to support multidisciplinary rehabilitative intervention in adults with Guillain-Barré syndrome (GBS) and "satisfactory" evidence for physical therapy in these patients. Evidence for other unidisciplinary interventions is limited or inconclusive.
For this review, the authors searched Medline, EMBASE, CINAHL, AMED, PEDro, LILACS, and the Cochrane Library up to March 2012 for studies reporting outcomes of GBS patients following rehabilitation interventions that addressed functional restoration and participation. Two reviewers applied the inclusion criteria to select potential studies and independently extracted data and assessed the methodological quality. Included studies were critically appraised using the GRADE methodological quality approach. Formal levels of evidence of each intervention were assigned using a standard format defined by the National Health and Medical Research Council.
Fourteen papers (1 systematic review, 1 randomized controlled trial, 1 case-control study, 5 cohort studies, and 6 case series/reports) that described a range of rehabilitation interventions for people with GBS were evaluated for the "best" evidence to date. One high-quality randomized controlled trial demonstrated effectiveness of higher intensity multidisciplinary ambulatory rehabilitation in reducing disability in people with GBS in the later stages of recovery, compared with lesser intensity rehabilitation intervention for up to 12 months. Four observational studies further demonstrated some support for improved disability and quality of life following inpatient multidisciplinary rehabilitation up to 12 months. Evidence for unidisciplinary rehabilitation interventions is limited, with "satisfactory" evidence for physical therapy in reducing fatigue, improving function, and quality of life in people with GBS.
The gaps in existing research should not be interpreted as ineffectiveness of rehabilitation intervention in GBS, the authors say. Further research is needed with appropriate study designs, outcome measurement, type of modalities, and cost effectiveness of these interventions.
Editor's Note: According to the full text article, "multidisciplinary rehabilitation" may include physical therapy.
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