Graded Aerobic and Resistance Training for Early Fatigue in Guillain–Barré Syndrome: A Clinical Case Report
Abstract
Background: Guillain–Barré syndrome (GBS) is an acute, immune-mediated neuropathy often causing weakness, sensory changes, and fatigue. Post-GBS fatigue is common and can persist even after strength recovery, limiting participation in daily activities. Evidence for safe, effective rehabilitation strategies targeting fatigue remains limited.
Case Presentation: We report the case of a 34-year-old male schoolteacher diagnosed with acute inflammatory demyelinating polyneuropathy (AIDP) following an upper-respiratory infection. After receiving intravenous immunoglobulin and initial inpatient care, he presented to outpatient neuro-physiotherapy four weeks post-onset with early fatigue despite improved muscle strength. Baseline assessments showed Fatigue Severity Scale (FSS) score of 6.1, 6-Minute Walk Test (6MWT) distance of 210 m, and mild residual lower-limb weakness.
Intervention: A progressive, closely monitored eight-week program of graded aerobic and resistance training was implemented. Aerobic sessions began at 40–50% heart-rate reserve, progressing in duration; resistance exercises targeted major limb muscles at 40% of one-repetition maximum, advancing cautiously while monitoring fatigue and overwork symptoms.
Outcomes: By week eight, the patient’s FSS improved to 3.8, 6MWT increased to 395 m, grip strength improved bilaterally, and perceived exertion during activity decreased. No adverse effects, overwork weakness, or disease relapse occurred. The patient reported increased energy and resumed part-time teaching.
Conclusion: Early, individualized, graded aerobic and resistance exercise can safely reduce fatigue and improve endurance in patients recovering from GBS. Careful pacing, symptom surveillance, and patient education are essential to optimize outcomes.
