Multidisciplinary care for Guillain-Barré syndrome

Khan, Fary; Ng, Louisa; Amatya, Bhasker; Brand, Caroline; Turner-Stokes, Lynne

doi:10.1002/14651858.cd008505.pub2

Cited by 45 publications

(35 citation statements)

References 70 publications

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“…Although RCTs are appropriate for studying the effects of an intervention and considered the 'gold standard' for high-level evidence, they are much less suited to studying 'complex' interventions such as rehabilitation 34 -36 . The many challenges in rehabilitation for traditional research designs include: heterogeneous interdependent components; different patient populations and contexts; and treatments that are multifaceted, multilayered and involve organizational restructure and individual intervention 33,34,36 . An alternative methodology is the use of 'clinical practice studies' that acquire prospective and retrospective observational data without disrupting the natural milieu of treatment 37 .…”

Section: Discussionmentioning

confidence: 99%

Systematic review of multidisciplinary rehabilitation in patients with multiple trauma

Khan

Amatya

Hoffman

2011

British Journal of Surgery

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Background: Multiple trauma is a cause of significant disability in adults of working age. Despite the implementation of trauma systems for improved coordination and organization of care, rehabilitation services are not yet routinely considered integral to trauma care processes. Results: No randomized and/or controlled clinical trials were identified. Fifteen observational studies involving 2386 participants with injuries were included. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach assessed methodological quality as 'poor' in all studies, with selection and observer bias. Although patients with low functional scores showed improvement after rehabilitation, they were unable to resume their pretrauma level of activity. Their functional ability was significantly associated with motor independence on admission and early acute rehabilitation, which contributed to a shorter hospital stay. Injury location, age, co-morbidity and education predicted long-term functional consequences. Trauma care systems were associated with reduced mortality. The gaps in evidence include: rehabilitation settings, components, intensity, duration and types of therapy, and long-term outcomes for survivors of multiple trauma. Conclusion:Rehabilitation is an expensive resource and the evidence to support its justification is needed urgently. The issues in study design and research methodology in rehabilitation are challenging. Opportunities to prioritize trauma rehabilitation, disability management and social reintegration of multiple injury survivors are discussed.

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Section: Discussionmentioning

confidence: 99%

Systematic review of multidisciplinary rehabilitation in patients with multiple trauma

Khan

Amatya

Hoffman

2011

British Journal of Surgery

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“…In most cases, the disease is preceded by an infection (Van Doorn, 2013) and may show seasonal variations in certain geographical regions (Webb et al, 2015). GBS is a disease associated with significant impairment and long-term disability (Khan et al, 2010). The natural course of the disease usually implies a slow recovery, leading to persistent, severe disability in 14% and at least minor functional disability in 40% of patients within the first year (Rajabally and Uncini, 2012).…”

Section: Introductionmentioning

confidence: 99%

Incidence of Guillain‐Barré syndrome in Chile: a population‐based study

Rivera-Lillo

Torres‐Castro

Burgos

et al. 2016

J Peripheral Nervous Sys

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The Guillain-Barré syndrome (GBS) incidence rate (IR) varies between 0.16 and 3.00 cases per 100,000 inhabitants. Little data exist on the epidemiology of GBS in Latin American countries. Our objective was to describe GBS epidemiology based on a national database in a Latin American country and to contribute to the global map of GBS epidemiology. This was a retrospective study that included all reported GBS cases in Chile between 2001 and 2012. Gender, age, seasonal occurrence, and geographical distribution were analyzed. A total of 4,158 GBS cases were identified from 19,513,655 registries. The mean age was 37 ± 24 years, and 59% of patients were male (male to female ratio of 1.5 : 1). Gender IR was 2.53/100,000 for males and 1.68/100,000 for females. The overall standardized IR was 2.1/100,000, although this varied between 1.61/100,000 (2001) and 2.35/100,000 (2010). The seasonal distribution was as follows: autumn 22%; winter 25%; spring 27%; and summer 26%. The geographical IR were as follows: far North 1.49/100,000; North 1.94/100,000; Central 1.97/100,000; South 3.18/100,000; and far South 2.78/100,000. The reported IR of GBS in Chile was similar to other studies based on national databases. In Chile, IR was greater in men and in the south.

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“…The pwGBS discharged into the community continue to improve over many months, but may have issues including urinary problems in the transition period, that may limit activity and restrict participation. Various studies suggest longer-term supportive care for pwGBS in the community 2,11,16. The existing studies12,13,17-21 however, report urinary dysfunction in acute phase of GBS only, while those in the chronic phase in the community have not been studied.…”

Section: Introductionmentioning

confidence: 99%

Guillain-Barré Syndrome: Prevalence and Long-Term Factors Impacting Bladder Function in an Australian Community Cohort

et al. 2013

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Background and PurposeUrinary dysfunction is associated with significant morbidity in persons with Guillain-Barré Syndrome (GBS). The aim of this study was to describe prevalence and long-term impact of bladder dysfunction on daily activities and quality of life (QoL) in persons in chronic phase of GBS and to examine the relationships between commonly used continence measures in this cohort.MethodsProspective cohort (n=66) following GBS treatment (1996-2009) was recruited from a tertiary hospital and assessed using standardised measures for bladder dysfunction: American Urological Association (AUA) Symptom Index, Incontinence Impact Questionnaire, Urogenital Distress Inventory.ResultsSixty-six participants (64% male, mean age 56 years, median disease duration of 6.1 years) completed the study. Of these more than half reported nocturia and one-third reported urinary urgency and frequency. Urinary problems impacted on participants' daily activities: physical recreation (21%), emotional health and mood (17%), entertainment (14%), participation and mobility (>30 min) (12%), and performance of household chores (8%). Since GBS, 49% reported interference of urinary symptoms with daily life to some extent; and adverse impact on QoL (10.6%). Significant relationship between bladder symptoms; and the level of urogenital distress (p<0.001) and the impact of urinary problems (p<0.001), was noted. Higher scores on the bladder scales showed significant correlations with psychological, functional and participation scales. The single QoL item (AUA scale) correlated significantly with all other bladder scales (rho=0.63-0.86). This can be a potential 'screening tool' to identify patients for further assessment.ConclusionsBladder dysfunction in chronic phase of GBS is not well studied. More research in longer-term screening and outcomes for bladder intervention are needed for integrated care and to guide treating clinicians.

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Multidisciplinary care for Guillain-Barré syndrome

Cited by 45 publications

References 70 publications

Systematic review of multidisciplinary rehabilitation in patients with multiple trauma

Systematic review of multidisciplinary rehabilitation in patients with multiple trauma

Incidence of Guillain‐Barré syndrome in Chile: a population‐based study

Guillain-Barré Syndrome: Prevalence and Long-Term Factors Impacting Bladder Function in an Australian Community Cohort

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