Fatigue in neuromuscular disorders: focus on Guillain–Barré syndrome and Pompe disease

Abstract

Fatigue accounts for an important part of the burden experienced by patients with neuromuscular disorders. Substantial high prevalence rates of fatigue are reported in a wide range of neuromuscular disorders, such as Guillain–Barré syndrome and Pompe disease. Fatigue can be subdivided into experienced fatigue and physiological fatigue. Physiological fatigue in turn can be of central or peripheral origin. Peripheral fatigue is an important contributor to fatigue in neuromuscular disorders, but in reaction to neuromuscular disease fatigue of central origin can be an important protective mechanism to restrict further damage. In most cases, severity of fatigue seems to be related with disease severity, possibly with the exception of fatigue occurring in a monophasic disorder like Guillain–Barré syndrome. Treatment of fatigue in neuromuscular disease starts with symptomatic treatment of the underlying disease. When symptoms of fatigue persist, non-pharmacological interventions, such as exercise and cognitive behavioral therapy, can be initiated.

The effectiveness of non-invasive ventilation in neuromuscular patients in KAMC

“…It decreases the incidence of shallow breathing, decreasing the carbon dioxide and increasing the oxygen in the blood. [13,14,16]. Even though there are studies which shows its effectiveness, there are many other studies which shows that NIV cannot be used for patients who have acute neuromuscular disorders like Guillain-Barre syndrome (GBS).…”

Guillain-Barré Syndrome and Care Management: Review

“…Öncesinde geçi-rilmiş enfeksiyon durumu, otonom işlev bozukluğu ve hastalığın psikososyol sonuçları yorgunluğun nedenleri olabilmektedir. 24 Yorgunluğun yönetimine altta yatan hastalı-ğın semptomatik tedavisi ile başlanmalı, daha sonra rehabilitasyon ve bilişsel davranışçı terapi gibi farmakolojik olmayan girişimler uygulanmalıdır. 24 Literatürde düzenli egzersiz yapılmasının yorgunluk düzeyini azaltmadaki etkisini araştıran pek çok ça-lışma bulunmaktadır.…”

“…24 Yorgunluğun yönetimine altta yatan hastalı-ğın semptomatik tedavisi ile başlanmalı, daha sonra rehabilitasyon ve bilişsel davranışçı terapi gibi farmakolojik olmayan girişimler uygulanmalıdır. 24 Literatürde düzenli egzersiz yapılmasının yorgunluk düzeyini azaltmadaki etkisini araştıran pek çok ça-lışma bulunmaktadır. Düzenli egzersiz,hastalarda enerji kaybını azaltır, işlevsel kapasiteyi artırır ve dolaşım sistemini hızlandırarak yorgunluğa neden olan sitokinlerin ve diğer maddelerin dolaşımdan atılmasını sağlar.…”

Comparison of the outcomes of home based and supervised individually designed exercise programme amongst the patients in chronic phase after guillain barre syndrome: study protocol for a randomized control trial

“…14 Fatigue is also reported on 60-80% of patient population as one of the common consequence and also associated with the poor quality of life and activity limitation. [15][16][17][18] A systematic review on effectiveness of exercises on patients with polyneuropathy has evaluated poor quality studies and only one trial which failed to show favourable effects of strengthening and endurance training on functional ability of the patients with polyneuropathy however, also suggested the moderate effect of exercises on increasing the muscle strength of the patients. 19 Further, some observational and prospective studies also have reported the improvement in function, fatigue and muscle strength of the patient after supervised cycling or prescribed unsupervised exercises and aerobic activities.…”