Guillain–Barré Syndrome & Biokinetics

Guillain-Barré syndrome nerve cell damage treated with physical therapy at Fish and Field Biokinetics

Guillain–Barré syndrome is not a term that many are familiar with, but a term we feel is important to make people aware of.  And due to it being more common in men than women, we thought it a relevant and interesting topic for our June Men’s Health Month. 

Overview

Guillain–Barré syndrome (GBS) is a rare disease in which your body’s immune system attacks your nervous system, damaging the nerve cells (neurons).  It can either affect the motor neurons which are the nerve cells that control muscle movement, or the sensory neurons which are the nerve cells that transmit signals such as pain, temperature, and touch.  It could also affect both, the motor neurons and the sensory neurons.  And therefore, generally, the first symptoms that present are tingling and weakness in your extremities.  Movements such as lifting your toes or picking up a coffee mug become impossible. The paralysis will spread throughout the body, moving either from your lower extremities to the upper body or vice versa, and requires hospitalisation to receive appropriate treatment.  There are 3 types of GBS, these include:

  • Acute Inflammatory Demyelinating Polyradiculoneuropathy (AIDP), with its most common sign being muscle weakness that starts in the lower body and moves up.
  • Miller Fisher Syndrome (MFS) in which paralysis starts in the eyes, with unsteady gait being another sign.
  • Acute Motor Axonal Neuropathy (AMAN) and Acute Motor- Sensory Axonal Neuropathy (AMSAN).  Due to the sensory neuron damage that occurs with AMSAN, affected individuals can lose the ability to sense the position of their limbs, as well as have abnormal or absent reflexes.

Causes of Guillain–Barré syndrome

Unfortunately, the cause of Guillain–Barré syndrome is not completely understood. However, research shows that GBS often follows after a viral or bacterial infection. With two thirds of patients reporting that they had symptoms of an infection 6 weeks prior to developing GBS.  Triggers such as recent surgery and vaccinations have also been reported.  Other risk factors include:

  • Being over the age of 50
  • As mentioned, the disorder is more common in men than women
  • Most commonly, infection with Campylobacter, a type of bacteria often found in undercooked poultry
  • Influenza virus
  • Cytomegalovirus
  • Epstein-Barr virus
  • Zika virus
  • Hepatitis A, B, C and E
  • HIV, the virus that causes AIDS
  • Mycoplasma pneumonia
  • Surgery
  • Trauma
  • Hodgkin’s Lymphoma
  • Rarely, influenza vaccinations or childhood vaccinations
  • COVID 19 virus
  • COVID 19 Johnson and Johnson vaccine

Treatment of Guillaine Barre Syndrome

There is no known cure for Guillain–Barré syndrome, unfortunately, BUT fortunately, there are treatments available.  2 treatments a patient will receive are:

Plasma exchange (plasmapheresis)

This is where the patient’s liquid part of the blood (plasma) gets removed from the body and separated from the blood cells.  The blood cells are then placed back into the body and will create new plasma.  By doing this the body is enabled to get rid of certain antibodies that were attacking the nervous system.

Immunoglobulin therapy

With this therapy, the patient receives blood with healthy antibodies (provided by donors) through a vein.  Thus, healthy antibodies can help block the antibodies that are attacking the body.

The sooner a patient receives treatment, the better the patient’s outcome.  Generally, signs and symptoms worsen over the first 2 – 4 weeks, plateaus around week 4, and recovery can take anywhere from 6 – 12 months.  For some severe cases, recovery can take up to 3 years.  And for all patients, there might be some lingering signs of GBS.

Physical Therapy

Due to the body’s nerves being damaged with Guillain–Barré syndrome, as well as it resulting in immobility, physical therapy is necessary, extensive, and should start from early days.  In the hospital the patient will be assisted by carers and physiotherapists: stretching muscles to avoid shortening and doing mobilisation techniques. Often a lot of chest therapy is required due to the patient being on ventilators. Carers will assist with moving the patient into different positions to avoid bedsores. And physiotherapists will slowly progress to small exercises to start the process of teaching the patient how to use their muscles again. The latter is often continued at a step-down facility.

The next step in therapy is for the patient to improve their muscle function, improve breathing function, and capacity, learn how to sit on their own again, hold a small object, lift their legs, learn to walk again, and reduce their fatigue levels.  And this is where we as Biokineticists step in.

Biokinetics

At Fish and Field Biokineticists we have treated many GBS patients. As a result, we have a good understanding of the disorder and what is required from us to assist the patient in their journey to recovery. As in all cases, treatment would start with an assessment which includes a patient history assessment and a physical assessment noting the patient’s current situation.  Included in the physical assessment we are able to provide our patients with objective results by making use of various testing equipment. This allows us to reassess the patient further down the line and provide them with a progress report comparing their latest outcomes with their initial outcomes.  Not only does this provide the patient with clear and accurate results but provides great encouragement for the patient when they are able to see their progression.

Depending on the patient’s assessment outcomes and circumstances, a program is designed to suit the patient’s specific needs (this includes exercises, what they are comfortable with in terms of being moved around if not capable of doing so themselves, the environment they are working in (private space or around other patients), etc.).  When starting with sessions, exercises could be performed in their wheelchair or lying down on a plinth for instance. 

Aqua-Therapy

We are also fortunate to have swimming pools at all our practices. These have hoist chairs to make access into and out of the pool easier. Aqua-Therapy early on allows the patient to ‘do more’ due to the support of the water. It also allows for freedom from being constrained to a bed, wheelchair or a chair. And helps with blood circulation, which is crucial when being immobile. The warm water also helps to reduce pain levels. 

As the patient progress in their recovery, more weight-bearing exercises are introduced and finally progress to more functional work. 

Find Support

Guillain–Barré syndrome, we can only imagine, is a frightful experience to live and work through.  Each individual that gets affected by this disorder would need to be extraordinarily strong mentally to help them get through the experience. And would need all the support they can get from family, friends, carers, and health professionals.  At Fish and Field Biokineticists we want to be part of that support group and help you on your road to recovery.

References

“GBS (Guillain-Barré Syndrome) and Vaccines | Vaccine Safety | CDC.” GBS (Guillain-Barré Syndrome) and Vaccines | Vaccine Safety | CDC, www.cdc.gov, 25 Aug. 2021, https://www.cdc.gov/vaccinesafety/concerns/guillain-barre-syndrome.html.

“Guillain-Barré Syndrome: MedlinePlus Genetics.” Guillain-Barré Syndrome: MedlinePlus Genetics, medlineplus.gov, 1 Sept. 2011, https://medlineplus.gov/genetics/condition/guillain-barre-syndrome/.

“Guillain-Barre Syndrome – Symptoms and Causes.” Mayo Clinic, www.mayoclinic.org, 23 July 2021, https://www.mayoclinic.org/diseases-conditions/guillain-barre-syndrome/symptoms-causes/syc-20362793#:~:text=Guillain%2DBarre%20(gee%2DYAH,eventually%20paralyzing%20your%20whole%20body.

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