Many GBS survivors experience persistent fatigue and weakness long after the acute phase has resolved. Studies suggest that between 20% and 67% of GBS survivors report significant residual fatigue at one year post-onset, and for some this persists for many years.
Understanding Residual Symptoms
Residual weakness in GBS may arise from incomplete axonal regeneration, central sensitisation, or deconditioning secondary to prolonged immobility during the acute illness. GBS-related fatigue has both peripheral and central components — peripheral fatigue relates to the increased energy cost of movement through weakened muscles, while central fatigue reflects changes in the central nervous system itself.
The Role of Physiotherapy
A graded exercise programme, individually tailored to the person’s current functional level and fatigue profile, is the cornerstone of long-term GBS rehabilitation. The programme should progressively increase in intensity as tolerance improves, with careful attention to pacing to avoid post-exertional symptom exacerbation. Outcome measures including the GBS Disability Score and Fatigue Severity Scale provide valuable objective data to guide progression.
References
Merkies, I.S.J. et al. (2013). Assessing grip strength in Guillain-Barré syndrome. Muscle & Nerve, 47(1), 15–21. https://doi.org/10.1002/mus.23491
Garssen, M.P.J. et al. (2007). Residual fatigue is independent of antecedent events and disease severity in Guillain-Barré syndrome. Journal of Neurology, 254(12), 1667–1673. https://doi.org/10.1007/s00415-007-0598-z
