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The overall purpose of this thesis was to examine the role of exercise in people with stable Peripheral Neuropathies (PN). A 12 week community based unsupervised exercise intervention in 16 people after Guillain-Barré syndrome (GBS) or with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and ten healthy controls demonstrated that the exercise intervention was well tolerated and acceptable. After the intervention, PN participants had significantly reduced activity limitations, participation restrictions and fatigue; these improvements were maintained at six month follow up. Some outcome tools used in the exercise study, demonstrated limitations and so three studies to modify and evaluate tools for assessing mobility and activity limitations were conducted. The results showed that the Walk-12, a walking questionnaire, and the modified Physiological Cost Index, which measures the energy used whilst walking, were valid for use in people with PN. However, whilst the modification to the Overall Disability Sum Score to form the Overall Neuropathy Limitations Scale resulted in greater sensitivity and face validity, its responsiveness was somewhat reduced. The fatigue profile of 13 people with PN was described and compared to healthy people, to identify potential contributors to fatigue. Despite significantly greater experienced fatigue, PN participants did not have abnormal muscle fatigue. However, the experienced fatigue was significantly associated with greater activity limitations and poorer functioning in PN participants and they had significantly reduced cardiovascular fitness, were weaker and less active than healthy participants. Although there are several limitations of the studies in this thesis, they indicate that exercise was practical and may be helpful in reducing activity limitations and fatigue in people with PN. The results also identify outcome tools to evaluate functioning and provide data to inform the development of a controlled trial to evaluate the efficacy of exercise to manage activity limitations and fatigue in people with PN. |
