Affiliations: [a] Department of Neurological Rehabilitation, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| [b] Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| [c] Division of Cardiovascular Medicine, Baruch Padeh Medical Center, Poriya, Israel
| [d] The Academic College at Wingate, Wingate Institute, Netanya, Israel
| [e] Department of Behavioral Sciences, Ariel University, Ariel, Israel
| [f]
The National Institute for the Rehabilitation of the Brain Injured, Tel Aviv, Israel
| [g] School of health professions, Ono academic college, Kiryat Ono, Israel
Correspondence:
[*]
Address for correspondence: Einat Engel-Haber, Department of Neurological Rehabilitation, Sheba Medical Center Tel Hashomer, Derech Sheba 2, Ramat Gan, Israel. Fax: +972 3 5352888; E-mail: einat.haber@sheba.health.gov.il.
Note: [1] Bondi and Engel-Haber contributed equally as first co-authors to this work.
Abstract: BACKGROUND:Treatment with either Intravenous immunoglobulin (IVIg) or plasma exchange (PE) in patients with Guillain-Barré Syndrome (GBS) showed equivalent efficacy as attested by a commonly used disability scale. However, it has been suggested that this scale may not be sensitive enough to detect subtle functional changes between the two treatments since it mainly focuses on walking capability and respiratory function. OBJECTIVE:To evaluate functional outcomes following treatment with IVIg or PE using comprehensive scales that incorporate parameters of basic activities of daily living. METHODS:A retrospective cohort study was conducted between 2007 and 2013 in an inpatient neurologic rehabilitation department. The study group included 70 individuals with GBS: 39 were treated with PE and 31 with IVIg. A comparison of functional outcomes was performed using Functional Independence Measure (FIM), rehabilitation efficiency (REy), rehabilitation effectiveness (REs), and the GBS disability scale (GDS). RESULTS:Both treatments had a comparable effect on the various functional outcomes. Patients showed a significant increase in total FIM scores (30 points on average) during rehabilitation mainly as a result of an increase in motor sub-scores. A mean improvement of 1.23 (SD 0.9) in GDS was also observed. On average, individuals with GBS spent 20 days combined in the acute departments and 61 days in the rehabilitation department, with length of stay being similar for both treatments. CONCLUSIONS:IVIg and PE treatments have similar basic activities of daily living (ADL) functional outcomes. Nevertheless, due to the different mechanism of actions of these treatments and the multitude of GBS variants, it is possible that further comprehensive assessment tools may demonstrate differences in activity and participation of individuals with GBS.
