New Study Highlights Value of Inpatient Rehabilitation for Guillain-Barré Patients

In a study published in the journal PLOS One, researchers at the University of Miami Miller School of Medicine and Encompass Health Rehabilitation Hospital System showed the value of inpatient rehabilitation for people recovering from Guillain-Barré syndrome (GBS). In addition, the research outlined specific functional health markers, such as effectively transferring from bed to chair or bed to wheelchair, that indicate patients may be ready to go home.

David S. Kushner, M.D.
David S. Kushner, M.D.

“Our study highlights the usefulness of inpatient rehabilitation in the recovery process for GBS patients,” said David Kushner, M.D., clinical professor of physical medicine and rehabilitation at the Miller School and first author on the paper. “This is the first U.S. national study investigating GBS patient outcomes following inpatient rehabilitation, and these findings suggest inpatient rehabilitation is effective in promoting functional recovery and discharges back to the home.”

GBS is a rare autoimmune condition in which the immune system attacks peripheral nerves, causing arm and leg weakness and impairing movement. Most patients recover fully, but it’s a rough road. Patients are often treated with intravenous gamma globulin and/or plasmapheresis, a dialysis-like procedure that washes autoimmune antibodies from their systems.

While some patients can go home directly from the hospital, most transfer to an inpatient rehabilitation facility to regain function. However, before this study, nobody had ever comprehensively investigated how much inpatient rehabilitation has benefited these patients.

‘The Goal Is to Get Patients Back Home’

The retrospective study looked at 1,304 patients, from around the U.S., who had been treated for GBS in inpatient rehab facilities. The patients were segmented into three groups based on their post-rehab destinations: home/community, skilled nursing or back to the hospital. Using a metric called functional independence measurement (FIM), the team found that patients in all three groups improved during rehab. Not surprisingly, the patients who improved the most went home.

“The goal is to get patients back home, and nearly 82% of the patients in the study were discharged back to the community,” said Dr. Kushner. “But overall, inpatient rehab helped all groups improve, and that was great to see.”

In addition, the study found that one of the most important factors associated with home/community discharge was a patient’s ability to regain the capacity to transfer from bed to chair or bed to wheelchair. The ability to walk or independently operate a wheelchair were also critical gains.

“That’s encouraging because these are key functions that are targeted during inpatient rehab,” said Dr. Kushner. “But it’s also important to educate families and caretakers before discharge so they feel more comfortable helping them with these tasks and taking these patients home. Knowing patients have that support makes it more likely they will be discharged home rather than going to a skilled nursing facility.”

Tags: Department of Physical Medicine and Rehabilitation, Dr. Davis Kushner, functional independence measurement, Guillain-Barre syndrome, inpatient rehabilitation, PLOS One