Role of physiotherapy for GBS disease or Guillain-Barre Syndrome
GBS disease can also be known as:
• Acute inflammatory demyelinating polyneuropathy
• Landry's ascending paralysis/ landrys paralysis
Nearly all patients can expect a sluggish but progressive recovery over many months. In severe cases the primaryconcern is maintaining vital functions and passively exercising the muscles. This sometimes requires temporary artificialbreathing machines for severely affected patients.
Plasmapheresis (plasma exchange). Plasmapheresis cleans your blood of damaging antibodies. The process removes the liquid part of your blood (plasma) and returns the red blood cells for your body. Over time, the body replaces the plasma which was removed.
Intravenous immune globulin. A kind of protein (immunoglobulin) contains healthy antibodies from blood donors. Within this procedure, a doctor inserts an intravenous (IV) line to your vein and injects high doses of immunoglobulin. These doses help block the harmful antibodies in your blood that could contribute to GBS disease.
Although many people recover from GBS disease, the duration of your illness is unpredictable, and could require months of hospital care and rehabilitation.
As nerve function returns, patient may require assistance to learn how to use affected muscles. Rehabilitation can include several types of therapy.
Physiotherapy. Physiotherapy stimulates joints and muscles to rebuild strength, flexibility and flexibility.
Occupational therapy. Occupational therapy concentrates on activities to help patient be as self-sufficient as you possibly can in daily life.
Assistive devices. patient might need to learn to use assistive devices, for example leg or arm braces, canes, walkers and wheelchairs to assist mobility during recovery or, if GBS causes permanent disabilities, for long-term use.
physiotherapy strategy to GBS disease will:
• Regain patient's independence with everyday tasks.
• Retrain normal movement patterns by teaching patient how you can achieve activities diversely.
• Muscle strength training, exercising as frequently as possible in the correct way.
• Stretch tight muscles and stop soft tissue contractures.
• Improve patient's posture in lying, sitting and standing and sleeping.
• Increase patient's mobility.
• Increase balance and coordination.
• Increase fitness and levels.
• Increased ability to relax.
• Promote recovery.
• educate about GBS disease and symptoms.
The role of physiotherapy for GBS disease could be divided into three parts -
• acute phase
• the middle phase of rehabilitation
• long-term, on-going rehabilitation
The key factor is communication with this particular multi-disciplinary approach with the purpose of the team to help the flow from the treatment of the patient.
The Acute Phase
Within the acute phase most of physio is perfect for respiratory care. Whether it affects the intercostal muscle - the onebetween the ribs that lifts in the ribs as we have a breath. Equally when the diaphragm is affected - negligence the body between the abdomen and also the chest - patient possess the inability to take a large breath. So in acute phase regular breathing workouts are necessary.
Phase of Rehabilitation
So then your first part of the rehabilitation phase begins. Whenever we start to get patients moving we must keep in mind the physiotherapy should be graduated. We realize the patients can fatigue quite quickly and thus we try to build up the strength very gradually, deliberately providing a bit more demand each time in exercising the respiratory muscles.
The career of the patient is essential. He/she needs to be nursed so that the lungs are kept clear - laterally and if need be to become "jacked up" with the head down so allowing any secretion within the lungs to be drained out.
Patient struggling with GBS disease often complain of severe pain, which may be managed by applying TENS, IFT along with other pain relieving techniques.
If muscles are saved in a shortened position of sufficient length then there is an increase in the stiffness from the muscle. So there must be "passive" movements, ie aided - with the full range at least once each day. If there is too much movement with weak muscles around some pot, the joint may become quite loose and hang up later some pain. Not enough movement and you get a stiff joint. You could have muscle stiffness after which joint stiffness. It can can become quite painful.
You will find available Resting Splints for wrist/hands as well as for ankles which can be essential in the early stages. Tight leg muscles can later on allow it to be more difficult for one to walk, particularly upstairs and downstairs as well as on a slight slope. You receive too tired.
The key feature at the next phase when patient gets up out of bed is that his/her circulation is very dependent on the muscles in your body.
There will be swelling within the ankles and hands if a person doesn't move around much. So a patient's blood pressure level is monitored at this time to check there is no sudden drop. Such patients wear elastic stockings to push the blood to the heart and also to prevent thrombus. If the blood sits within the legs there is more possibility of clotting.
Some patients with weak stomach muscles may need abdominal corsets. When the patient is getting in the whole effect of the items gravity has on the joints becomes important. The shoulder joint particularly depends on its muscles around it. He/she may require the arms supported in early stages of sitting upright and walking.
You should get good seating. If required one can make do having a cushion, towel or pillow to aid the lumbar spine. Prolonged sitting having a curved spine can result in small damage to the joints inside your upper spine, producing backache. It's similarly important to offer the middle and the surface of the spine as well as the arms.
Stretching the arms such as the hands, legs such as the feet, body (particularly by slumping), helps you to rehabilitate not only the peripheral muscles but additionally, we believe, the associated nerves. This will be significant for GBS and CIDP patients struggling with nerve damage. One must be careful not to overstretch.
Functional tasks of everyday living that involve exercise are usually beneficial. These tasks include walking, repeated sitting to standing, allowing this to continue and moving up and down during sex, putting on and removing clothes. These tasks assistance to restore the patient to normalcy living.
Hydrotherapy treatments are fantastic as patient can float; so how much they weigh is supported as well as can exercise from the graded resistance from the water - the faster they move greater it is, the slower the greater gentle. It does not suit everyone - some discover the heat too much.
You should watch the posture as muscle weakness can impact it. IT is often the physio's role to nag and provide patient advice about posture.
The individual may need balance retraining because we all know the ankles are essential for balance. The individual may find the hips need to be moved to keep the balance.
As patient progress only then do we begin some learning advanced skills of walking down and up slopes and stairs.
Being an ongoing practice you should have regular exercises to help keep stretching muscles which may be at risk of tightening up - leg muscles, hamstrings, arm muscles.
Hydrotherapy, walking, stationary bikes or anything that could possibly get patient's heart rate up are essential for ensuring that your cardiovascular and general fitness have been in good condition.