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PT MANAGEMENT OF GBS

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Keerthi Priya
Keerthi Priya

This document discusses Guillain-Barré syndrome (GBS), including its definition, clinical features, assessment scales, and phases. It defines GBS as an acute/subacute symmetrical motor neuropathy involving more than one peripheral nerve. The phases of GBS are described as the acute, plateau, and recovery phases. For each phase, goals of physical therapy and examples of interventions are provided, such as chest physiotherapy, positioning, stretching, and strengthening exercises to address weaknesses and functional limitations during the different stages of GBS.

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PT MX OF GBS KEERTHI PRIYA MPT NEURO, ASSISTANT PROFESSOR
GBS DEFINITION : Acute/sub acute symmetrical motor neuropathy involving more than one peripheral nerve. AIDP: Acute Idiopathic Demyelinating Polyneuropathy AIP: Acute Infective /Idiopathic Polyneuropathy Landry Gullian Barrie Strohl Syndrome
Clinical Features  symmetrical weakness Progress distal to proximal Distal sensory impairment Hypaesthesia & paraesthesia Myalgia Dysarthria Dysphagia B/L Facial weakness Diplopia Sphincter disturbances Orthostatic hypotension Tachycardia Arrhythmia
Diseased specified scales  Gullian barrie syndrome disability score  Huges functional grading scale for GBS Erasmus GBS Outcome Score
PHASES OF GBS 1. Acute Phase 2. Plateau Phase 3. Recovery Phase
ACUTE PHASE  Weakness of limbs Involvement of respiratory muscles Areflexia paraesthesia
ACUTE PHASE Goals : To prevent lung infections To maintain chest mobility To prevent contractures To prevent bedsores To maintain circulation To reduce pain
ACUTE PHASE PT MX : To prevent lung infections: Chest physiotherapy Postural drainage Suctioning Stretching of chest wall & trunk rotations Rib springing
ACUTE PHASE PT MX : To prevent contractures: Positioning Splinting Passive ROM
ACUTE PHASE PT MX : To prevent bedsores: Positioning Water bed Pneumatic rings Maintain hygiene
ACUTE PHASE PT MX : To maintain circulation:  ankle toe movements Stockings Elevation
ACUTE PHASE PT MX : To decrease pain: TENS PROM Massage
PLATEAU PHASE Goals : To improve lung capacities To maintain chest mobility To maintain muscle properties To prevent autonomic dysfunctions To improve swallowing & speaking
PLATEAU PHASE PT MX : To improve lung capacities:  Breathing exercises Incentive spirometer Coughing techniques PNF exercises
PLATEAU PHASE PT MX : To maintain muscle properties:  Facilitatory techniques Assisted exercises Electrical stimulation Sitting & standing over tilt table
Recovery PHASE Goals : To maintain lung capacities To increase muscle strength To improve balance & coordination To decrease fatigue To make patient independent
Recovery PHASE PT MX : To increase muscle strength:  Graded strengthening exercises Endurance training  resistance training Weight bearing
Recovery PHASE PT MX : To improve balance & coordination:  static balance training ( pelvic bridging, pertubations, Single leg weight bearing) Dynamic balance training( wooble board, functional reach activities, trampoline, Swiss ball exercises) Coordination exercises
Recovery PHASE PT MX : Gait Training:  walking over parallel bars Walking without support Walking on different surfaces Stair climbing
Recovery PHASE PT MX Functional Training:  ADL activities FES
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PT MANAGEMENT OF GBS

  • 1. PT MX OF GBS KEERTHI PRIYA MPT NEURO, ASSISTANT PROFESSOR
  • 2. GBS DEFINITION : Acute/sub acute symmetrical motor neuropathy involving more than one peripheral nerve. AIDP: Acute Idiopathic Demyelinating Polyneuropathy AIP: Acute Infective /Idiopathic Polyneuropathy Landry Gullian Barrie Strohl Syndrome
  • 3. Clinical Features  symmetrical weakness Progress distal to proximal Distal sensory impairment Hypaesthesia & paraesthesia Myalgia Dysarthria Dysphagia B/L Facial weakness Diplopia Sphincter disturbances Orthostatic hypotension Tachycardia Arrhythmia
  • 4. Diseased specified scales  Gullian barrie syndrome disability score  Huges functional grading scale for GBS Erasmus GBS Outcome Score
  • 5. PHASES OF GBS 1. Acute Phase 2. Plateau Phase 3. Recovery Phase
  • 6. ACUTE PHASE  Weakness of limbs Involvement of respiratory muscles Areflexia paraesthesia
  • 7. ACUTE PHASE Goals : To prevent lung infections To maintain chest mobility To prevent contractures To prevent bedsores To maintain circulation To reduce pain
  • 8. ACUTE PHASE PT MX : To prevent lung infections: Chest physiotherapy Postural drainage Suctioning Stretching of chest wall & trunk rotations Rib springing
  • 9. ACUTE PHASE PT MX : To prevent contractures: Positioning Splinting Passive ROM
  • 10. ACUTE PHASE PT MX : To prevent bedsores: Positioning Water bed Pneumatic rings Maintain hygiene
  • 11. ACUTE PHASE PT MX : To maintain circulation:  ankle toe movements Stockings Elevation
  • 12. ACUTE PHASE PT MX : To decrease pain: TENS PROM Massage
  • 13. PLATEAU PHASE Goals : To improve lung capacities To maintain chest mobility To maintain muscle properties To prevent autonomic dysfunctions To improve swallowing & speaking
  • 14. PLATEAU PHASE PT MX : To improve lung capacities:  Breathing exercises Incentive spirometer Coughing techniques PNF exercises
  • 15. PLATEAU PHASE PT MX : To maintain muscle properties:  Facilitatory techniques Assisted exercises Electrical stimulation Sitting & standing over tilt table
  • 16. Recovery PHASE Goals : To maintain lung capacities To increase muscle strength To improve balance & coordination To decrease fatigue To make patient independent
  • 17. Recovery PHASE PT MX : To increase muscle strength:  Graded strengthening exercises Endurance training  resistance training Weight bearing
  • 18. Recovery PHASE PT MX : To improve balance & coordination:  static balance training ( pelvic bridging, pertubations, Single leg weight bearing) Dynamic balance training( wooble board, functional reach activities, trampoline, Swiss ball exercises) Coordination exercises
  • 19. Recovery PHASE PT MX : Gait Training:  walking over parallel bars Walking without support Walking on different surfaces Stair climbing
  • 20. Recovery PHASE PT MX Functional Training:  ADL activities FES