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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
ANY QUERY
THANK YOU

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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