A Multidisciplinary Extended Approach to Physiotherapy Rehabilitation in Guillain-Barre Syndrome as Sequelae of COVID-19: A Single Case Study
Abstract
Introduction: Coronaviruses can cause widespread systemic infections, the most common of which are respiratory complications, which are close to the symptoms of serious acute respiratory syndrome coronavirus (SARS-CoV).
Case Description: We report a case of a 16-year-old boy who developed weakness in bilateral lower limbs, difficulty in coughing, and generalized weakness for 2 days. He was diagnosed with post-COVID Guillain-Barre syndrome (GBS). Cerebrospinal fluid (CSF) analysis manifested a CSF protein of 117 mg/dL, a white blood cell count of 6-7/mm3, and a glucose of too low to comment. Magnetic resonance investigation of the brain revealed mucosal thickening in the bilateral maxillary, ethmoid, and left frontal sinuses. Nerve conduction studies concluded evidence of sensory-motor polyneuropathy. Physiotherapy intervention included patient education, breathing retraining, airway clearance techniques, positioning, a combination of chest proprioceptive neuromuscular facilitation (PNF) techniques, a walking program with supplemented oxygen, and psychological support.
Results: Outcome measures have shown enhancement in functional independence and performance of activities of daily living.
Conclusion: The evidence from this study suggests that pulmonary rehabilitation plays a pivotal role in managing a patient who is diagnosed with post-COVID GBS, which includes patient education, breathing retraining, airway clearing techniques, a combination of chest PNF techniques, positioning, a walking program with augmented oxygen, and psychological support.
Wobeto WP, Zani BB, da Silva Esteves AB, da Silva Marangoni MV, Pinatti ND, Pedro KN, et al. Guillain-barre syndrome: Case study and literature review. Immunome Research. 2019; 15(3):1-4. [Link]
Zade R, Sahu P, Shende G, Phansopkar P, Dadgal R. Comprehensive physical therapy improves functional recovery in a rare case of stroke associated with asthma: A case report. Medical Science. 2020; 24(105):2893-9. [Link]
Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol. 2020; 77(6):683-90. [PMID]
Zubair AS, McAlpine LS, Gardin T, Farhadian S, Kuruvilla DE, Spudich S. Neuropathogenesis and neurologic manifestations of the coronaviruses in the age of coronavirus disease 2019: A review. JAMA Neurology. 2020; 77(8):1018-27. [DOI:10.1001/jamaneurol.2020.2065] [PMID] [PMCID]
Sedaghat Z, Karimi N. Guillain Barre syndrome associated with COVID-19 infection: A case report. Journal of Clinical Neuroscience. 2020; 76:233-5. [DOI:10.1016/j.jocn.2020.04.062] [PMID] [PMCID]
Camdessanche JP, Morel J, Pozzetto B, Paul S, Tholance Y, Botelho-Nevers E. COVID-19 may induce Guillain-Barré syndrome. Revue Neurologique. 2020; 176(6):516-8. [DOI:10.1016/j.neurol.2020.04.003] [PMID] [PMCID]
Živković V, Gačić EM, Djukić D, Nikolić S. Guillain-barré syndrome as a fatal complication of SARS-CoV-2 infection-An autopsy case. Legal Medicine. 2022; 57:102074. [DOI:10.1016/j.legalmed.2022.102074] [PMID] [PMCID]
Montalvan V, Lee J, Bueso T, De Toledo J, Rivas K. Neurological manifestations of COVID-19 and other coronavirus infections: A systematic review. Clinical Neurology and Neurosurgery. 2020; 194:105921. [DOI:10.1016/j.clineuro.2020.105921] [PMID] [PMCID]
Xie Z, Hui H, Zhao Z, Yu W, Wu R, Zhu Y, et al. Nervous system manifestations related to COVID-19 and their possible mechanisms. Brain Research Bulletin. 2022; 187:63-74. [DOI:10.1016/j.brainresbull.2022.06.014] [PMID] [PMCID]
Shamsi S, Mugheeb T, Khan S. Physiotherapy Management of COVID-19. International Journal of Science and Healthcare Research. 2020; 5(3):108-16. [Link]
Leonhard SE, Mandarakas MR, Gondim FAA, Bateman K, Ferreira MLB, Cornblath DR, et al. Diagnosis and management of Guillain-Barré syndrome in ten steps. Nature Reviews. 2019; 15(11):671-83. [DOI:10.1038/s41582-019-0250-9] [PMID] [PMCID]
Demeco A, Marotta N, Barletta M, Pino I, Marinaro C, Petraroli A, et al. Rehabilitation of patients post-COVID-19 infection: A literature review. The Journal of International Medical Research. 2020; 48(8):300060520948382. [DOI:10.1177/0300060520948382] [PMID] [PMCID]
Bawiskar D, Phansopkar P, Gotmare AV. COVID-19 facets: Pandemics, curse and humanity. International Journal of Research in Pharmaceutical Sciences. 2020; 11(SPL1):385-90. [DOI:10.26452/ijrps.v11iSPL1.2731]
Bawiskar D, Dhote S, Phansopkar P. Early physical rehabilitation post-surgery in a complex type 5 schatzker tibial plateau fracture improves functional outcomes: A case report. Medical Science. 2020; 24(104):2675-82. [Link]
Caress JB, Castoro RJ, Simmons Z, Scelsa SN, Lewis RA, Ahlawat A, et al. COVID-19-associated Guillain-Barré syndrome: The early pandemic experience. Muscle & Nerve. 2020; 62(4):485-91. [DOI:10.1002/mus.27024] [PMID] [PMCID]
Ramani SL, Samet J, Franz CK, Hsieh C, Nguyen CV, Horbinski C, et al. Musculoskeletal involvement of COVID-19: Review of imaging. Skeletal Radiology. 2021; 50(9):1763-73. [DOI:10.1007/s00256-021-03734-7] [PMID] [PMCID]
Issue | Vol 18 No 2 (2024) | |
Section | Case Report(s) | |
DOI | https://doi.org/10.18502/jmr.v18i2.15984 | |
Keywords | ||
Functional independence Guillain-Barre syndrome Rehabilitation Severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |