La sindrome di Guillain-Barré è la più frequente forma di polineuropatia acquisita dovuta a demielinizzazione (degenerazione delle guaine mieliniche che rivestono le fibre nervose). Nonostante la causa all’origine di questa patologia non sia ancora stata identificata con certezza assoluta, attualmente viene annoverata tra le polineuropatie immuno-mediate poiché la maggior parte degli studi condotti fino a oggi porta a ritenere che la causa sia autoimmune.
I pazienti che sopravvivono alla fase acuta della sindrome di Guillain-Barrè possono sviluppare diversi tipi di disabilità. La nostra revisione pubblicata su Expert Review of Neurotherapeutics ha evidenziato che ci sono poche prove di qualità nella riabilitazione della Guillain-Barrè. Tuttavia, essa viene eseguita ampiamente nella pratica clinica, e per questo motivo sono necessari studi di qualità superiore con alti livelli di evidenza.
The efficacy of rehabilitation in people with Guillain-Barrè syndrome: a systematic review of randomized controlled trials
Introduction
Individuals with Guillain-Barrè syndrome (GBS) showed significant longer-term psychological sequelae, due to persistent disability. In recent years, great advances have been made in medical care for patients with GBS. However, the focus has been mainly on patient care in the acute phase and improving survival instead of long-term disability. The purpose of this study was to evaluate the efficacy of rehabilitation in people with GBS through a systematic review of randomized controlled trials.
Area Covered
PRISMA guidelines were used to perform this systematic review. Six bibliographic databases were searched: PUBMED, WEB OF SCIENCE, PEDro, CINHAL, PSYCHINFO, and SCOPUS. Papers included in the systematic review should have a search design of a randomized controlled trial. The quality of the clinical trials included was evaluated according to Jadad score.
Expert Opinion
After eliminating duplicates, 472 records got screened, three RCTs were included in the systematic review. Overall, the analysis of the three randomized controlled trials showed that various types of rehabilitation interventions are correlated to an improvement in the patient’s well-being. Finally, it is not possible to extrapolate definite conclusions on the effectiveness of rehabilitation treatment in patients with GBS. Therefore, high-quality future studies are needed to confirm these hypotheses.
Article highlights
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The aim of this systematic review was to evaluate the efficacy of rehabilitation in people with Guillain-Barrè syndrome.
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A total of 748 studies were retrieved from the search and 141 were evaluated after the first screening. After excluding 138 studies, 3 suitable randomized controlled trials were included.
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The analysis of the three randomized controlled trials showed that various types of rehabilitation interventions are correlated to an improvement in the patient’s well-being.
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Patients who survive the acute phase of Guillain-Barrè syndrome can develop different types of disabilities. Only one RCT evaluated different outcomes and used a multidisciplinary approach for the treatment of GBS.
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Our review highlighted that there is little quality evidence in Guillain-Barrè rehabilitation. However, it is performed extensively in clinical practice, and for this reason, higher quality studies with high levels of evidence are required.
Sulli, S., Scala, L., Berardi, A., Conte, A., Baione, V., Belvisi, D., Leodori, G. and Galeoto, G., 2021. The efficacy of rehabilitation in people with Guillain-Barrè syndrome: a systematic review of randomized controlled trials. Expert Review of Neurotherapeutics.
