Occupational Therapy management for Guillain Barre Syndrome

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Rabeya Ferdous | Published: January 24, 2015 00:00:00 | Updated: November 30, 2026 06:01:00

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Guillain-Barre Syndrome (GBS) is a disorder in which the body's immune system attacks part of the peripheral nervous system. The first symptoms of this disorder include varying degrees of weakness or tingling sensations in the legs. In many instances the symmetrical weakness and abnormal sensations spread to the arms and upper body.
Signs and symptoms of Guillain-Barre Syndrome may include:
l Prickling, "pins and needles" sensations in your fingers, toes, ankles or wrists
l Weakness in your legs that spreads to your upper body
l Unsteady walking or inability to walk or climb stairs
l Difficulty with eye or facial movements, including speaking, chewing or swallowing
l Severe pain that may feel achy or cramp-like and may be worse at night
l Difficulty with bladder control or bowel function
l Rapid heart rate
l Low or high blood pressure
l Difficulty breathing
One Case Scenario
Rohan is a 19 years old boy. He lives in Gazipur. His father is a teacher in primary school. He is the only child of his parents. Everyone likes him very much. He likes to do his work sincerely and listen to the instruction of his parents. His relatives also like him. He is popular at his college as a brilliant student and good cricketer. He wants to be a doctor because most of the poor people in his village cannot take treatment for financial problem. So he wants to provide treatment to these poor people. That's why he tried his best and got A+ in both SSC and HSC.
Later, he comes alone to Dhaka in his aunt's house for taking the admission test for enrolment in a medical college. After one day when he gets up from bed he feels that he cannot move his leg and hand properly. Then slowly he sits from bed and stands but feels acute weakness and pain in his body. He thinks it will be cured soon. But gradually it starts increasing. In two days it affects his body and severe pain attacks his body. He cannot move any part of his body. After two days he got admitted in hospital. There he stays one month. In this time some of his friends appear in admission test and got admitted in different medical colleges. Gradually he becomes depressed. Doctors of the hospital refer him to Centre for Rehabilitation of the Paralysed (CRP) for better therapeutic treatment. Therapists said he needs more time for cure. But, prognosis depends on patient's condition. Now he takes Occupational Therapy for being independent in daily activities and physiotherapy. His condition is improving day by day.
The main focus of Occupational Therapy is remedial, while compensatory techniques should be considered to allow performance of some activities in the early stages. An individual's strength and endurance are important factors when formulating a proper treatment plan.
Other treatment includes:
e  Facilitate proper positioning by providing splints for preventing further deformity
e  Maintain Join Range of Motion by involving different types of activity.
e  Graded strengthening activity
e Practice activities for decrease joint stiffness and increase fine motor coordination
e  Discuss joint protection principles with the patient and those individuals involved with treatment implementation, and incorporate sensory stimulation and neuromuscular re-education.
e  Teaching stress management and relaxation techniques are helpful in addressing anxiety associated with the disease process.
e Finally, provide positive feedback and encouragement; try to lessen the patient's anxiety about potential dependency
e  Practice Activities of Daily Living (ADLs) like eating, dressing, writing, grooming etc.
Prognosis
Nearly 95 per cent of all patients survive GBS; however, a number of patients never recover completely. Typically, the prognosis improves if symptoms do not persist beyond three weeks of the initial onset. About three per cent may suffer a relapse of muscle weakness and tingling sensations many years after the initial attack.
If you have any relatives with GBS then please contact with qualified occupational therapists who can rehabilitate the patients in their daily life. Centre for the Rehabilitation of the Paralyzed (CRP) is the only centre where this type of patients gets this facility. Please contact following address:
Centre for the Rehabilitation of the Paralyzed (CRP) Savar, Dhaka. Tel: (880)2 7745464/5; Fax: (880)2 7745069    email: contact@crp-bangladesh.org
CRP has also a different branch at Mipur-14, Dhaka, Sylhet, Chittagong and Barisal.
The writer is Clinical Occupational Therapist, CRP-Mirpur, Dhaka.
Email: rabeya1988@gmail.com