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Guillain-Barré Syndrome Physiotherapy

Guillain-Barré syndrome (GBS) is an autoimmune disorder that affects our  nerves and how our nerves function in the body.

GBS is not inherited, nor is it contagious, and the exact cause of the disorder is not known despite research studies to date. However, research has shown that approximately two-thirds of GBS cases happen following

• bacterial or viral infections or
• after immunizations

Unfortunatley, it can also occur with no identified trigger.

GBS is rare, and occurs in fewer than 4 per 100,000 people worldwide, and slightly more often in men. It can affect both adults and children; its affects do not vary across race, ethnicity, or geographic location. The incidence of GBS increases with age, with average onset at 40 years of age. In the United States, diagnoses of GBS peak in young adulthood (ages 15 to 35 years), and at a second higher peak in persons aged 50 to 75 years. Physical therapists design individualized treatment programs to help people with GBS regain movement and return to their preferred daily activities.

Guillain-Barré Syndrome

Guillain-Barré syndrome (GBS) is an autoimmune condition in which the immune system attacks nerves in the affected patient’s own body, destroying the outer insulation layers of the peripheral nerves (nerves other than those in the brain and spinal cord).

GBS can cause damage that results in serious health problems.  

Quite often, GBS occurs after a viral or bacterial infection, such as:

• Epstein-Barr virus
• Hepatitis viruses
• Mononucleosis
• Chicken pox and other herpes infections
• Pneumonia

Research has shown that GBS also can occur following some immunizations (such as those for rabies and swine flu). Other possible triggers include infection by insect-carried organisms such as:

• Zika virus
• West Nile virus
• Lyme disease

Food-borne organisms also have been known to trigger GBS in people who have ingested contaminated food. Sexually-transmitted viruses and bacteria have been linked to the onset of GBS as well.

Signs and Symptoms

GBS can cause a variety of signs and symptoms, including:

• Muscle weakness, often occurring equally on the right and left sides of the body, starting in the feet and moving up toward the trunk
• Sensation changes, such as numbness and tingling
• Autonomic nerve dysfunction, such as problems with sweating, digestion, heart rate, incontinence, vision
• Nerve pain, muscle pain, and/or joint pain

How Is It Diagnosed?

GBS is usually diagnosed by your doctor.

When you are referred for physiotherapy, our senior physiotherapist will conduct a thorough evaluation that includes taking your health history.

We will also ask you detailed questions about your condition, such as:

• How and when did the symptoms start?
• Have the symptoms changed over time?
• What daily activities, hobbies, or work skills are you having trouble doing?
• What is your current activity level?

We will perform tests on your body to find physical problems, such as:

• Weakness or tightness in the muscles
• Loss of skin sensation in some areas (numbness)
• Loss of reflexes
• Joint stiffness
• Poor posture
• Balance problems
• Breathing difficulty
• Skin problems

If we find any of the above problems, physical therapy treatment may begin right away to help get you on the road to recovery and back to your normal activities.

If severe medical problems are found with any of the testing, we may collaborate with a doctor or surgeon to obtain special diagnostic testing or treatment.

Our senior physiotherapists work closely with physicians and other health care providers to ensure that you receive the treatment and care needed.

how our senior physiotherapists can help

Once you have been diagnosed with GBS and referred to physiotherapy, we will work with you to design a specific treatment program that will improve your recovery, including exercises and treatments that you can do on your own.

Physical therapy will help you return, as much as possible, to your normal lifestyle and activities. The time it takes to help heal the condition varies for each person, but results can start to be felt in a few weeks to a month.

Depending on your condition, your physical therapist may work with you to improve your:

Comfort level

GBS may cause pain or discomfort. We may show you how to use pillows to make your body position more comfortable in a chair or when lying down.

We also may use technologies, such as gentle heat or electrical stimulation to help decrease your pain and alleviate your symptoms, and teach you gentle exercises or techniques to perform on your own to relieve discomfort.

All of these options may reduce or eliminate the need for pain medication, including opioids.

Skin and joint protection

We will check your skin frequently to make sure that it stays healthy and injury free during your recovery. We may apply splints to parts of your arms and legs to protect your joints or to keep them gently stretched out.

We will also teach you (and your caregivers or family) skin care and protection methods.

Walking ability

We will help improve your ability to walk using techniques such as

• strengthening exercises
• walking training
• and balance training

If you have nerve damage (neuropathy), we may provide bracing and other techniques to make it easier or safer for you to walk. We also may recommend using an assistive device, such as a walker or cane.

Aerobic capacity

Research shows that aerobic exercise, such as walking on a treadmill for at least 20 minutes 3 times per week, may help improve aerobic capacity, reduce fatigue, and optimize healing.

We can assess your aerobic capacity and determine the best aerobic activities for you. We will teach you how to conserve energy and avoid overworking your body, so that healing can occur and relapse is avoided.

If you have needed a ventilator in the past to help you breathe, we will work with you to help improve your breathing endurance during activities like walking.

Motion

We will choose specific activities and treatments to help restore normal movement in any stiff joints or muscles. These might begin with "passive" motions that we do for you, and progress to active exercises and stretches that you do yourself. You can perform these motions on your own, when able, to help hasten improved motion and pain relief.

Ability to move around

We will teach you and your caregiver or family how to help you move around safely, and help you regain the ability to

• move from your bed to a chair
• sit down
• stand up
• walk
• climb stairs
• use a wheelchair
• and perform any other daily activity with which you have difficulty

Flexibility

We will determine if any muscles are tight, start helping you to stretch them, and teach you how to stretch them on your own.

Strength

If we find any weak or injured muscles, we will choose, and teach you, the correct exercises to steadily restore your strength and agility.

Coordination

We will help you improve and regain your coordination and agility so you can perform household, community, and sports activities with greater ease.

Balance

We will examine your balance, and choose specific exercises you can perform in the clinic and on your own to improve your balance and prevent falls. We also may teach you how to use a cane or walker to help maintain your balance when walking and standing.

Independent activities

We will teach you strengthening, stretching, and pain-reduction exercises to perform on your own. These exercises will be designed specifically for your needs, to help restore your ability to perform daily activities.

Participation in favorite activities

We can help you return to your preferred recreational activities over time, using a rehabilitation program designed just for you.

Family support

Your family’s knowledge of your condition will benefit you and them. We can help teach them how best to support you during your recovery.