Guillain-Barré Syndrome (GBS) is a rare but serious autoimmune disorder in which the body’s immune system mistakenly attacks the peripheral nerves. This condition often results in muscle weakness, paralysis, and sensory disturbances, making everyday tasks daunting for those affected. Although the exact cause of GBS remains unknown, it is commonly triggered by an infection, such as a respiratory or gastrointestinal illness. Recovery from GBS can be slow and challenging, but physiotherapy plays a crucial role in helping patients regain strength, mobility, and independence.

Understanding Guillain-Barré Syndrome

GBS typically begins with tingling and weakness in the extremities, which can rapidly progress to paralysis. The condition is characterised by an acute phase, where symptoms can worsen over days to weeks, followed by a plateau phase, and finally, a recovery phase. During the recovery phase, which can last for months or even years, the nerves slowly heal, and muscle strength gradually returns. However, the extent of recovery varies among individuals, with some experiencing lasting effects such as fatigue, pain, or weakness.

The Role of Physiotherapy in GBS Recovery

Physiotherapy is an essential component of the multidisciplinary approach to managing GBS. It begins in the acute phase and continues through to the recovery phase, adapting to the patient’s changing needs as they regain function.
Acute Phase: Preventing Complications

In the acute phase, when the patient may be immobilised due to weakness or paralysis, the primary goals of physiotherapy are to prevent complications and maintain body function. The physiotherapist focuses on:

Positioning and Stretching: Proper positioning in bed and gentle passive stretching of the limbs helps prevent joint contractures and pressure sores, which can occur when the body is immobile for extended periods.

Respiratory Support: Respiratory muscles can be affected in GBS, so physiotherapists often work with patients to maintain lung function. Techniques such as deep breathing exercises and assisted coughing help to prevent respiratory complications like pneumonia.

Pain Management: Neuropathic pain is common in GBS. Physiotherapists may use modalities like heat therapy or transcutaneous electrical nerve stimulation (TENS) to manage pain.

Plateau Phase: Gradual Rehabilitation

As the patient stabilises and enters the plateau phase, the focus of physiotherapy shifts towards maintaining flexibility and starting gentle muscle strengthening exercises. The key interventions include:

Range of Motion Exercises: These exercises maintain joint flexibility and prevent stiffness. The physiotherapist may assist the patient with passive exercises or encourage active participation if strength permits.

Gradual Strengthening: Low-resistance exercises are introduced to begin rebuilding muscle strength without causing fatigue or overexertion.

Functional Training: As strength improves, patients start working on basic functional tasks like sitting up, standing, and eventually walking with support. The focus may also turn to improving upper limb function for reaching tasks, eating and drinking, and other essential daily tasks.

Recovery Phase: Restoring Function

In the recovery phase, physiotherapy becomes more intensive and goal-oriented, focusing on restoring the patient’s functional abilities and improving their quality of life. Key components include:

Progressive Strengthening: Exercises become more challenging as the patient’s strength returns. Resistance training and functional exercises, such as stair climbing and balance activities, are emphasised.

Gait Training: Relearning how to walk is often a significant aspect of rehabilitation. Physiotherapists work with patients on gait training, using assistive devices like walkers or braces as needed. It is vital to improve the overall gait technique to enhance an individual’s potential to re-gain ‘normal movement patterns’ for walking.

Endurance Training: As patients regain their strength, endurance training is incorporated to improve cardiovascular fitness and reduce fatigue.

Patient Education: Educating patients and their families about GBS, the importance of pacing activities, and strategies for energy conservation is crucial for long-term management.

Conclusion

Physiotherapy is indispensable in the journey of recovery from Guillain-Barré Syndrome. Through tailored interventions that evolve with the patient’s progress, physiotherapists help individuals regain mobility, strength, and independence. While the road to recovery can be long, with the right support, many GBS patients can achieve significant improvements in their quality of life