OBSERVER-BLIND RANDOMISED CONTROLLED TRIAL TO EVALUATE THE EFFICACY OF A TWELVE WEEK TAILORED HOME EXERCISE PROGRAMME IN THE MANAGEMENT OF INFLAMMATORY NEUROPATHY

Persistent activity limitation and fatigue affect a substantial proportion of people with inflammatory neuropathy (IN) due to Guillain‐Barré syndrome (GBS), chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) or paraproteinemic demyelinating neuropathy (PDN). Observational studies suggest that participation in regular exercise may reduce activity limitation but no randomised controlled trials have been conducted. Therefore, in the current pragmatic trial, 58 adults with stable motor neuropathy were randomised to receive either standard care plus written advice about physical activity (advice, n = 30) or standard care plus a physiotherapist prescribed tailored home exercise programme (exercise, n = 28). Patient reported outcomes, including the primary outcome of activity limitation at 12 months using the Rasch Overall Disability Scale (R‐ODS), were assessed at baseline, 12 weeks and 12 months. Secondary outcomes included fatigue, physical activity, mood, self‐efficacy and illness perceptions as well as quality of life. Multiple linear regression analysis showed that group allocation, age, gender and baseline severity were unable to predict change in activity limitation (R‐ODS) either at the primary endpoint of 12 months (p = 0.653) or at 12 weeks (p = 0.302). Analysis of secondary outcomes revealed a significant effect of group allocation at 12 weeks for mood using the Hospital Anxiety &Depression Scale (HADS) total score (p = 0.001), HADS anxiety (p = 0.019) and HADS depression scores (p = 0.001) as well as for fatigue using the Rasch based Fatigue Severity Scale (RFSS) (p = 0.042) with the exercise group reporting greater improvements than the advice group. In addition, at 12 month follow up, the exercise group reported significantly less concern about their condition as measured by the Brief Illness Perceptions Questionnaire (BIPQ) (p = 0.022). The results suggest that participation in tailored home exercise has no effect on activity limitation but gives short term improvement in mood and fatigue for people with IN and a longer term impact on their concerns about their condition.