Reported fatigue in people after Guillain-Barré Syndrome: a retrospective national survey in the UK

Stockley, R, Walton, T, Brissenden, S, Campbell, M and Davidson, I (2013) Reported fatigue in people after Guillain-Barré Syndrome: a retrospective national survey in the UK. Italian journal of Phsyiotherapy (now Archives of Physiotherapy), 3 (4). pp. 154-160.

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Abstract

Aim. Despite continuing functional recovery over time, fatigue remains a persistent feature of post-acute GuillainBarré Syndrome (GBS). The aim of this study was to determine the prevalence of fatigue in people after GBS and investigate its associations with other factors after GBS. Methods. Validated questionnaires including the SF-36 and fatigue severity scale were sent to members of the GBS support group, a UK wide patient and carer organisation. Results. A total of 884 questionnaires were returned (58% response rate). Respondents’ answers demonstrated that those with severe fatigue following GBS had spent longer in hospital than those who were not severely fatigued (P=0.003). Poorer mental health was also associated with more severe fatigue. A strong predictor of prolonged fatigue was discharge from hospital in a wheelchair (OR=2.37, 95% CI 1.52 to 3.71, P<0.001) but the severity of fatigue appeared to be independent of recovery of mobility (Kendall’s taub=0.03, P=0.2). Conclusion. This survey is the largest study of fatigue in people after GBS. Its findings demonstrate that fatigue remains a persistent problem for many people after GBS. More severe fatigue was associated with decreased health related quality of life and increased levels of depression and anxiety in people after GBS. Whilst the severity of fatigue was significantly associated with poorer mobility on discharge, there was no association between the recovery of mobility after discharge and fatigue severity. This indicates that whilst other impairments and activity limitations improved over time, fatigue did not and implies that more severe fatigue is not simply an indicator of a more severe presentation of GBS. Whilst the reasons for persistent severe fatigue remain unclear, this study indicates that further investigations of mobility, mental health and fatigue are warranted so that targeted interventions can be put in place to manage this debilitating complication. (It J Physiotherapy 2013;3:154-60)