title: Outcomes of high- and low-intensity rehabilitation programme for persons in chronic phase after Guillain-Barré syndrome: a randomized controlled trial.
abstract: 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.
  
  
  METHODS
  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%.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Medicine, Dentistry and Health sciences, The University of Melbourne, Royal Melbourne Hospital, Poplar Road, Parkville, Melbourne, VIC-3052, Australia. fary.khan@mh.org.au
authors.forename: Fary
authors.initials: F
authors.lastname: Khan
authors.forename: Julie F
authors.initials: JF
authors.lastname: Pallant
authors.forename: Bhasker
authors.initials: B
authors.lastname: Amatya
authors.forename: Louisa
authors.initials: L
authors.lastname: Ng
authors.forename: Alexandra
authors.initials: A
authors.lastname: Gorelik
authors.forename: Caroline
authors.initials: C
authors.lastname: Brand
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D020275:Guillain-Barre Syndrome / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D057187:Independent Living; D059012:Lost to Follow-Up; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D015397:Program Evaluation; D011788:Quality of Life; D020127:Recovery of Function