Guillain Barre Syndrome: occupational therapy management

Every student has plan for his future. But sometimes it cannot be fulfilled due to different problems like financial crisis or lack of optimum results needed for admission. Sometimes a person’s plan for his future may get shattered by a natural calamity or a disfiguring disease or condition. Guillain Barre Syndrome or GBS is on such disease which can cripple a person for life. There is no known cause of GBS. It is preceded by an infectious illness.
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.

Rabeya Ferdous Occupational Therapist National Institute of Neurosciences & Hospital(NINS), Dhaka Email: [email protected],

Signs and symptoms of Guillain-Barre syndrome may include:
Prickling, "pins and needles" sensations in your fingers, toes, ankles or wrists
Weakness in your legs that spreads to your upper body
Unsteady walking or inability to walk or climb stairs
Difficulty with eye or facial movements, including speaking, chewing or swallowing
Severe pain that may feel achy or cramp-like and may be worse at night
Difficulty with bladder control or bowel function
Rapid heart rate
Low or high blood pressure
Difficulty breathing
One case scenario
Rohan is a 19 years old boy. He lives in Gazipur. His father is a primary school teacher. He is the only child of his parents. Everyone likes him very much. He likes to do his work sincerely and he is obedient to his parents. His relatives also like him. He is popular in his college as a brilliant student and a good cricketer. He wants to be a doctor because most of the poor people in his village cannot afford treatment and Rohan wants to help them. That’s why he worked hard for his grades and got A+ in both SSC and HSC. After that he came to Dhaka to his aunt’s house for the Medical College admission test. One or two days later he developed a severe weakness of his arms and legs, the sort of which he never felt before.  He managed to sit and stand with great effort but the pain and weakness was very severe. He thought it will get better soon. But the paralysis and pain got worse. Soon afterwards Rohan could not move at all. After two days he got admitted to hospital. There he stayed for a whole month. GBS is a disease capable of paralyzing the muscles of respiration and once respiratory muscle paralysis occurs; the risk of mortality is very high. After receiving prolonged treatment, and facing the brunt of depression and overwhelming sadness Rohan was referred to Centre for Rehabilitation (CRP) for treatment of his disabilities. Therapists at CRP say he needs more time for cure. But, prognosis also depends on the patient’s condition. Now he takes occupational therapy for independence in daily activities and physiotherapy. His condition is improving gradually.
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.
Physiotherapy comprises mostly of:
Facilitate proper positioning by providing splints for preventing further deformity
Maintain Join Range of Motion by involving different types of activity.
Graded strengthening activity
Practice activities for decrease joint stiffness and increase fine motor coordination
Discuss joint protection principles with the patient and those individuals involved with treatment implementation, and incorporate sensory stimulation and neuromuscular re-education.
Teaching stress management and relaxation techniques are helpful in addressing anxiety associated with the disease process.
Finally, provide positive feedback and encouragement; try to lessen the patient's anxiety about potential dependency
Practice Activities of Daily Living (ADLs) like eating, dressing, writing, grooming etc.
Prognosis
Nearly 95 percent 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 percent may suffer a relapse of muscle weakness and tingling sensations many years after the initial attack.

 

 

Guillain Barre Syndrome: occupational therapy management

Every student has plan for his future. But sometimes it cannot be fulfilled due to different problems like financial crisis or lack of optimum results needed for admission. Sometimes a persons plan for his future may get shattered by a natural calamity or a disfiguring disease or condition. Guillain Barre Syndrome or GBS is on such disease which can cripple a person for life. There is no known cause of GBS. It is preceded by an infectious illness. Guillain-Barre syndrome (GBS) is a disorder in which the bodys 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. Rabeya Ferdous Occupational Therapist National Institute of Neurosciences Hospital(NINS), Dhaka Email: [email protected], Signs and symptoms of Guillain-Barre syndrome may include: Prickling, pins and needles sensations in your fingers, toes, ankles or wrists Weakness in your legs that spreads to your upper body Unsteady walking or inability to walk or climb stairs Difficulty with eye or facial movements, including speaking, chewing or swallowing Severe pain that may feel achy or cramp-like and may be worse at night Difficulty with bladder control or bowel function Rapid heart rate Low or high blood pressure Difficulty breathing One case scenario Rohan is a 19 years old boy. He lives in Gazipur. His father is a primary school teacher. He is the only child of his parents. Everyone likes him very much. He likes to do his work sincerely and he is obedient to his parents. His relatives also like him. He is popular in his college as a brilliant student and a good cricketer. He wants to be a doctor because most of the poor people in his village cannot afford treatment and Rohan wants to help them. Thats why he worked hard for his grades and got A+ in both SSC and HSC. After that he came to Dhaka to his aunts house for the Medical College admission test. One or two days later he developed a severe weakness of his arms and legs, the sort of which he never felt before. He managed to sit and stand with great effort but the pain and weakness was very severe. He thought it will get better soon. But the paralysis and pain got worse. Soon afterwards Rohan could not move at all. After two days he got admitted to hospital. There he stayed for a whole month. GBS is a disease capable of paralyzing the muscles of respiration and once respiratory muscle paralysis occurs; the risk of mortality is very high. After receiving prolonged treatment, and facing the brunt of depression and overwhelming sadness Rohan was referred to Centre for Rehabilitation (CRP) for treatment of his disabilities. Therapists at CRP say he needs more time for cure. But, prognosis also depends on the patients condition. Now he takes occupational therapy for independence in daily activities and physiotherapy. His condition is improving gradually. 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 individuals strength and endurance are important factors when formulating a proper treatment plan. Physiotherapy comprises mostly of: Facilitate proper positioning by providing splints for preventing further deformity Maintain Join Range of Motion by involving different types of activity. Graded strengthening activity Practice activities for decrease joint stiffness and increase fine motor coordination Discuss joint protection principles with the patient and those individuals involved with treatment implementation, and incorporate sensory stimulation and neuromuscular re-education. Teaching stress management and relaxation techniques are helpful in addressing anxiety associated with the disease process. Finally, provide positive feedback and encouragement; try to lessen the patients anxiety about potential dependency Practice Activities of Daily Living (ADLs) like eating, dressing, writing, grooming etc. Prognosis Nearly 95 percent 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 percent may suffer a relapse of muscle weakness and tingling sensations many years after the initial attack.