Guillain-Barre Syndrome Support Group

Registered Charity 327314

GUIDE

After GBS — Exercise

This series of guides is produced by the Guillain-Barré Syndrome Support Group. We are a registered charity that supports those affected by the Guillain-Barré syndrome (GBS) and related conditions in the United Kingdom and the Republic of Ireland. The related conditions include chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and Miller Fisher syndrome (MFS).

Our guides are easily downloaded from our Web site at www.gbs.org.uk in PDF format and may be both read and printed using free Adobe Reader software. Alternatively, you can request printed copies from our office.

by Claire Strickland, Chartered Physiotherapist, St Bartholomew’s Hospital, London. First published in After GBS, edited by Jane Tempest-Roe, Administrator GBS Support Group.

Reviewed 2005 by Dr Claire White.

PDF version suitable for printing

The severity of GBS can be variable and this is true both for the speed and pattern of recovery. You may experience changes or improvements in your residual symptoms for some months, sometimes years after discharge from hospital or a rehabilitation unit.

During the recovery stages, physiotherapy, occupational therapy (OT) and speech and language therapy play a vital role in the rehabilitation process as well as maximizing functional ability. At some point during rehabilitation the rate of recovery will plateau and it is often at this point that patients will be discharged from all the support services on which they may have relied. It is also possible that patients may be placed ‘on review’. This means that you may be followed up at regular intervals and can telephone for advice in-between but don’t attend the clinic as often as you did before.

You are likely to be left with some residual problems but, even if you appear symptom free, simple fatigue may become evident as you return home and take on more activities. It may therefore be wise to consider pacing yourself as you return to family life, work and hobbies and exercise may also be recommended.

The role of exercise in the ongoing rehabilitation for patients with GBS is still to some extent unclear and clinical trials are being carried out to improve our understanding. However, there is already some evidence that where weakness and fatigue are problems, participation in regular graded exercise can be beneficial.

It is important that prior to starting regular exercise you seek advice from your GP, consultant or a physiotherapist. For example, in some cases severe weakness around joints may make them vulnerable to damage during exercising and special splints or orthoses may be needed to protect such joints. In addition you should not exercise excessively as it is still unclear whether over-exercising may actually make some problems worse and may make you feel more fatigued.

However, where medical problems do not exist, then even patients with severe residual problems, including fatigue, may benefit from fatigue management and/or a graded exercise plan. Such a plan may include gentle strengthening exercises for weak muscles, specific functional activities eg walking up and down stairs, getting up from sitting to standing and back down again, and graded aerobic exercise eg walking, cycling, swimming or running etc.

Exercising in this way can help to improve your muscle strength and reduce your overall sense of fatigue. There are also general benefits of this type of exercise in boosting the immune system, helping your heart and lungs remain healthy and making you feel better about yourself. However, it may take weeks or even months before you feel the benefit of exercise so it is important to pace yourself. Therefore you should be encouraged to seek advice on whether and how to start regular exercise.

If after reading this guide you still have anxieties and unanswered questions, telephone our helpline on 0800 374803 (UK) or 0044 1529 415278 (RoI). Alternatively, you can e-mail us or register for support on-line.

The GBS Support Group is a registered charity and receives neither government nor Lottery funding. If you have found this guide helpful and would like to help us to continue publishing copies for others affected by GBS and its related conditions, please consider making a donation to the Support Group. Secure donations may be made on line. Alternatively you can request a form from our office

GBS Support Group, LCC Offices, Eastgate, SLEAFORD, NG34 7EB

Tel: 01529 304615 E-mail: admin@gbs.org.uk Web site: www.gbs.org.uk

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