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Kikkawa T, Takashima A. Practice of gait training using lower-limb orthosis and body weight-supported walker for severe acute motor axonal neuropathy: a case report. JAPANESE JOURNAL OF COMPREHENSIVE REHABILITATION SCIENCE 2023; 14:49-53. [PMID: 37859787 PMCID: PMC10585010 DOI: 10.11336/jjcrs.14.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/01/2023] [Indexed: 10/21/2023]
Abstract
Kikkawa T, Takashima A. Practice of gait training using lower-limb orthosis and body weight-supported walker for severe acute motor axonal neuropathy: a case report. Jpn J Compr Rehabil Sci 2023; 14: 49-53. Introduction Acute motor axonal neuropathy (AMAN) requires aggressive gait rehabilitation from the early phase of its onset due to the long time required to achieve independent gait. In this report, we describe the progress of gait training using a combination of lower-limb orthosis and body weight-supported (BWS) walker in a patient with severe AMAN. Case A 30-year-olds man diagnosed with AMAN underwent two high-dose intravenous immunoglobulin treatments and combined steroid pulse therapy. The patient was admitted to the convalescent rehabilitation ward for 87 days with a Medical Research Council (MRC) score of 7 points for muscle strength and 13 points for Functional Independence Measure (FIM) motor items. He started gait training with a knee-ankle-foot orthosis on the 128th day. Thereafter, the distance of gait training increased with the use of lower-limb orthosis and BWS walker. At the time of discharge, the patient's MRC score had improved to 24 points and his FIM motor items score to 31 points. He was able to walk 90 m using ankle-foot orthosis and forearm walker and was transferred to a rehabilitation facility on day 237. Discussion Gait training with lower-limb orthosis and BWS walker was performed on a patient with severe AMAN. As a result, gait training distance increased without adverse events. Gait training can be performed safely and effectively by combining lower-limb orthosis and BWS walker when gait ability is expected to improve, even in severely ill patients.
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Affiliation(s)
- Taishi Kikkawa
- Department of Rehabilitation, Ushioda General Hospital, Kanagawa, Japan
| | - Akemi Takashima
- Department of Neurology, Ushioda General Hospital, Kanagawa, Japan
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Gupta A, Ranga A, Prakash NB, Khanna M. Rehabilitation outcomes in patients with post-COVID-19 vaccine-associated Guillain-Barre syndrome. J Neurosci Rural Pract 2022; 13:684-690. [PMID: 36743741 PMCID: PMC9893936 DOI: 10.25259/jnrp-2022-6-26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 09/20/2022] [Indexed: 12/05/2022] Open
Abstract
Objective With COVID-19 vaccination campaign worldwide, associated Guillain-Barre syndrome (GBS) is being increasingly reported from different countries. The objectives of the study were to observe the clinical profile and rehabilitation outcomes in patients with post-COVID-19 vaccine-associated GBS. Material and Method This prospective study was conducted in neurological rehabilitation unit with in-patients. A detailed customized rehabilitation program was formulated based on the clinical status and associated complications. Outcome measures were documented on the day of admission and at discharge and compared. Results The study included 16 patients (eight males) of which 15 (93.75%) received the CoviShield (AstraZeneca) and 1 Covaxin (Bharat Biotech) vaccine. The median (IQR) duration of first symptom was 9 (18.25) days and for motor symptoms 18 (12.75) days. Functional improvement was observed in patients using Barthel index scores and Hughes disability scores and overall neuropathy limitation scale. All rehabilitation outcomes showed a statistically significant improvement (P < 0.05) from the time of admission to discharge. At discharge, complete independence in activities of daily living was achieved in 4 (25%) patients and 5 (31.25%) were minimally dependent. Three (18.75%) patients were walking independently, seven (43.75%) with minimal support, and four with walker (25%). Nine (56.25%) patients needed bilateral ankle-foot orthosis and two bilateral knee gaiters for locomotion. Conclusion Comprehensive inpatient rehabilitation interventions in patients with post-COVID-19 vaccine-associated GBS result in significant functional recovery.
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Affiliation(s)
- Anupam Gupta
- Department of Neurological Rehabilitation, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Anurag Ranga
- Department of Neurological Rehabilitation, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Naveen B Prakash
- Department of Neurological Rehabilitation, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Meeka Khanna
- Department of Neurological Rehabilitation, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Tanaka M, Wada Y, Kawate N. Effectiveness of gait training with lower limb orthosis for a patient with severe Guillain-Barré syndrome at a Kaifukuki rehabilitation ward. JAPANESE JOURNAL OF COMPREHENSIVE REHABILITATION SCIENCE 2021; 12:48-52. [PMID: 37860205 PMCID: PMC10545041 DOI: 10.11336/jjcrs.12.48] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/27/2021] [Indexed: 10/21/2023]
Abstract
Tanaka M, Wada Y, Kawate N. Effectiveness of gait training with lower limb orthosis for a patient with severe Guillain-Barré syndrome at a Kaifukuki rehabilitation ward. Jpn J Compr Rehabil Sci 2021; 12: 48-52. Introduction We report the case of a patient with severe Guillain-Barré syndrome (GBS), whose ambulation recovered despite requiring total assistance on admission to a Kaifukuki rehabilitation ward. Gait training using knee-ankle-foot and ankle-foot orthoses was highly effective, based on the improvement in lower extremity muscle strength. Case A female in her 20s was previously diagnosed with GBS and was transferred to a Kaifukuki rehabilitation ward on hospitalization day 57. On admission, the lower extremities had a manual muscle test grade of 1, and the functional independence measure motor score (mFIM) was 13. She began training to stand upright using a tilt table and a knee-ankle-foot orthosis. Gait training with an adjustable posterior strut ankle-foot orthosis was initiated from 9 weeks after admission, with the fixed, brake, resistance, and freedom settings of the orthosis for the ankle joint adjusted according to the improvement in lower extremity muscle strength. At discharge, she was ambulatory without assistive devices and foot orthoses, and her mFIM had improved to 91. She returned to work 2 months later. Discussion This report describes the effectiveness of standing and gait training with a foot orthosis in improving ambulation in a severe GBS patient admitted to a Kaifukuki rehabilitation ward. Medical management and high-intensity rehabilitation are essential for patients with severe GBS during Kaifukuki rehabilitation.
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Affiliation(s)
- Midori Tanaka
- Department of Rehabilitation Medicine, School of Medicine, Showa University, Tokyo, Japan
- Showa University Fujigaoka Rehabilitation Hospital, Kanagawa, Japan
| | - Yoshitaka Wada
- Department of Rehabilitation Medicine, School of Medicine, Showa University, Tokyo, Japan
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Aichi, Japan
| | - Nobuyuki Kawate
- Department of Rehabilitation Medicine, School of Medicine, Showa University, Tokyo, Japan
- Showa University Fujigaoka Rehabilitation Hospital, Kanagawa, Japan
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Bondi M, Engel-Haber E, Wolff J, Grosman-Rimon L, Bloch A, Zeilig G. Functional outcomes following inpatient rehabilitation of Guillain-Barré syndrome patients: Intravenous immunoglobulins versus plasma exchange. NeuroRehabilitation 2021; 48:543-551. [PMID: 34024788 DOI: 10.3233/nre-201640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Treatment with either Intravenous immunoglobulin (IVIg) or plasma exchange (PE) in patients with Guillain-Barré Syndrome (GBS) showed equivalent efficacy as attested by a commonly used disability scale. However, it has been suggested that this scale may not be sensitive enough to detect subtle functional changes between the two treatments since it mainly focuses on walking capability and respiratory function. OBJECTIVE To evaluate functional outcomes following treatment with IVIg or PE using comprehensive scales that incorporate parameters of basic activities of daily living. METHODS A retrospective cohort study was conducted between 2007 and 2013 in an inpatient neurologic rehabilitation department. The study group included 70 individuals with GBS: 39 were treated with PE and 31 with IVIg. A comparison of functional outcomes was performed using Functional Independence Measure (FIM), rehabilitation efficiency (REy), rehabilitation effectiveness (REs), and the GBS disability scale (GDS). RESULTS Both treatments had a comparable effect on the various functional outcomes. Patients showed a significant increase in total FIM scores (30 points on average) during rehabilitation mainly as a result of an increase in motor sub-scores. A mean improvement of 1.23 (SD 0.9) in GDS was also observed. On average, individuals with GBS spent 20 days combined in the acute departments and 61 days in the rehabilitation department, with length of stay being similar for both treatments. CONCLUSIONS IVIg and PE treatments have similar basic activities of daily living (ADL) functional outcomes. Nevertheless, due to the different mechanism of actions of these treatments and the multitude of GBS variants, it is possible that further comprehensive assessment tools may demonstrate differences in activity and participation of individuals with GBS.
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Affiliation(s)
- Moshe Bondi
- Department of Neurological Rehabilitation, The Chaim Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Einat Engel-Haber
- Department of Neurological Rehabilitation, The Chaim Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Julie Wolff
- Department of Neurological Rehabilitation, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Liza Grosman-Rimon
- Division of Cardiovascular Medicine, Baruch Padeh Medical Center, Poriya, Israel.,The Academic College at Wingate, Wingate Institute, Netanya, Israel
| | - Ayala Bloch
- Department of Behavioral Sciences, Ariel University, Ariel, Israel.,The National Institute for the Rehabilitation of the Brain Injured, Tel Aviv, Israel
| | - Gabi Zeilig
- Department of Neurological Rehabilitation, The Chaim Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.,School of health professions, Ono academic college, Kiryat Ono, Israel
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Akanuwe JNA, Laparidou D, Curtis F, Jackson J, Hodgson TL, Siriwardena AN. Exploring the experiences of having Guillain-Barré Syndrome: A qualitative interview study. Health Expect 2020; 23:1338-1349. [PMID: 32748526 PMCID: PMC7696117 DOI: 10.1111/hex.13116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 06/15/2020] [Accepted: 07/14/2020] [Indexed: 12/01/2022] Open
Abstract
Background Guillain‐Barré syndrome (GBS) is a rare inflammatory disorder affecting the peripheral nerves. Although typically there is full neurological recovery, some people continue to experience residual physical, psychological or social problems longer term. Evidence describing the experiences of people with GBS is limited. Objective We aimed to explore the experiences of people with GBS in the UK. Design We used qualitative (face‐to‐face and telephone) interviews to explore experiences of people with GBS. Audio‐recorded data were transcribed verbatim and analysed using the Framework Method supported by NVivo 11. Setting and Participants We purposively recruited a sample of 16 volunteers with a prior diagnosis of GBS of varying age, sex, ethnicity, location, marital status, time since diagnosis and length of hospital stay to maximize differences in experience. Interviewees were required to have been discharged from hospital, able to give informed consent, able to speak and understand English and currently resident in the United Kingdom. Results The key themes arising from the analysis were as follows: the importance of early diagnosis; the experiences of inpatient care; the importance of active support for recovery; the need for communication throughout the course of the illness; the need for greater awareness, knowledge and provision of information by health‐care staff; and path to achieving function. Conclusion This is the first qualitative study exploring experiences of people with GBS in the UK through their whole illness journey from onset to recovery. The findings contribute to our understanding of the experiences and support needs of people recovering from GBS.
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Affiliation(s)
- Joseph N A Akanuwe
- Community and Health Research Unit (CaHRU), School of Health and Social Care, University of Lincoln, Lincoln, UK
| | - Despina Laparidou
- Community and Health Research Unit (CaHRU), School of Health and Social Care, University of Lincoln, Lincoln, UK
| | - Ffion Curtis
- Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, UK
| | - Jennifer Jackson
- Lincoln International Business School, University of Lincoln, Lincoln, UK
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Gupta A, Patil M, Khanna M, Krishnan R, Taly AB. Guillain-Barre Syndrome in Postpartum Period: Rehabilitation Issues and Outcome - Three Case Reports. J Neurosci Rural Pract 2019; 8:475-477. [PMID: 28694640 PMCID: PMC5488581 DOI: 10.4103/jnrp.jnrp_474_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
We report three females who developed Guillain–Barre Syndrome in postpartum period (within 6 weeks of delivery) and were admitted in the Neurological Rehabilitation Department for rehabilitation after the initial diagnosis and treatment in the Department of Neurology. The first case, axonal variant (acute motor axonal neuropathy [AMAN]) had worst presentation at the time of admission, recovered well by the time of discharge. The second case, acute motor sensory axonal neuropathy variant and the third case, AMAN variant presented at the late postpartum period. Medical treatment was sought much later due to various reasons and both the patients had an incomplete recovery at discharge. Apart from their presentations, rehabilitation management is also discussed in some detail.
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Affiliation(s)
- Anupam Gupta
- Department of Neurological Rehabilitation, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Maitreyi Patil
- Department of Neurological Rehabilitation, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Meeka Khanna
- Department of Neurological Rehabilitation, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Rashmi Krishnan
- Department of Neurological Rehabilitation, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Arun B Taly
- Department of Neurology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
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Walteros DM, Soares J, Styczynski AR, Abrams JY, Galindo-Buitrago JI, Acosta-Reyes J, Bravo-Ribero E, Arteta ZE, Solano-Sanchez A, Prieto FE, Gonzalez-Duarte M, Navarro-Lechuga E, Salinas JL, Belay ED, Schonberger LB, Damon IK, Ospina ML, Sejvar JJ. Long-term outcomes of Guillain-Barré syndrome possibly associated with Zika virus infection. PLoS One 2019; 14:e0220049. [PMID: 31369576 PMCID: PMC6675241 DOI: 10.1371/journal.pone.0220049] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 07/08/2019] [Indexed: 01/09/2023] Open
Abstract
Background This prospective cohort investigation analyzed the long-term functional and neurologic outcomes of patients with Zika virus-associated Guillain-Barré syndrome (GBS) in Barranquilla, Colombia. Methods Thirty-four Zika virus-associated GBS cases were assessed a median of 17 months following acute GBS illness. We assessed demographics, results of Overall Disability Sum Scores (ODSS), Hughes Disability Score (HDS), Zung Depression Scale (ZDS), and Health Related Quality of Life (HRQL) questionnaires; and compared outcomes indices with a normative sample of neighborhood-selected control subjects in Barranquilla without GBS. Results Median age at time of acute neurologic onset was 49 years (range, 10–80); 17 (50%) were male. No deaths occurred. At long-term follow-up, 25 (73%) patients had a HDS 0–1, indicating complete / near complete recovery. Among the group, HDS (mean 1.4, range 0–4), ODSS (mean 1.9, range 0–9) and ZDS score (mean 34.4, range 20–56) indicated mild / moderate ongoing disability. Adjusting for age and sex, Zika virus-associated GBS cases were similar to a population comparison group (n = 368) in Barranquilla without GBS in terms of prevalence of physical or mental health complaints, though GBS patients were more likely to have an ODSS of ≥ 1 (OR 8.8, 95% CI 3.2–24.5) and to suffer from moderate / moderate-severe depression (OR 3.89, 95% CI 1.23–11.17) than the comparison group. Conclusions Long-term outcomes of Zika virus-associated GBS are consistent with those associated with other antecedent antigenic stimuli in terms of mortality and ongoing long-term morbidity, as published in the literature. Persons with Zika virus-associated GBS more frequently reported disability and depression after approximately one year compared with those without GBS.
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Affiliation(s)
| | - Jesus Soares
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Ashley R. Styczynski
- Stanford University Department of Infectious Diseases, Palo Alto, California, United States of America
| | - Joseph Y. Abrams
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | | | | | | | | | | | | | | | | | - Jorge L. Salinas
- University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States of America
| | - Ermias D. Belay
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | | | - Inger K. Damon
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | | | - James J. Sejvar
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- * E-mail:
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Sebastián UU, Ricardo AVA, Alvarez BC, Cubides A, Luna AF, Arroyo-Parejo M, Acuña CE, Quintero AV, Villareal OC, Pinillos OS, Vieda E, Bello M, Peña S, Dueñas-Castell C, Rodriguez GMV, Ranero JLM, López RLM, Olaya SG, Vergara JC, Tandazo A, Ospina JPS, Leyton Soto IM, Fowler RA, Marshall JC. Zika virus-induced neurological critical illness in Latin America: Severe Guillain-Barre Syndrome and encephalitis. J Crit Care 2017; 42:275-281. [PMID: 28806562 PMCID: PMC7127615 DOI: 10.1016/j.jcrc.2017.07.038] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 06/30/2017] [Accepted: 07/20/2017] [Indexed: 12/13/2022]
Abstract
Zika virus (ZIKAV) is classically described as causing minor symptoms in adult patients, however neurologic complications have been recognized. The recent outbreak in Central and South America has resulted in serious illness in some adult patients. We report adult patients in Latin America diagnosed with ZIKAV infection admitted to Intensive Care Units (ICUs). METHODS Multicenter, prospective case series of adult patients with laboratory diagnosis of ZIKAV in 16 ICUs in 8 countries. RESULTS Between December 1st 2015 and April 2nd 2016, 16 ICUs in 8 countries enrolled 49 critically ill patients with diagnosis of ZIKAV infection. We included 10 critically ill patients with ZIKAV infection, as diagnosed with RT-PCR, admitted to the ICU. Neurologic manifestations concordant with Guillain-Barre Syndrome (GBS) were present in all patients, although 2 evolved into an encephalitis-like picture. 2 cases died, one due to encephalitis, the other septic shock. CONCLUSIONS Differing from what was usually reported, ZIKAV infection can result in life-threatening neurologic illness in adults, including GBS and encephalitis. Collaborative reporting to identify severe illness from an emerging pathogen can provide valuable insights into disease epidemiology and clinical presentation, and inform public health authorities about acute care priorities.
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Affiliation(s)
- Ugarte Ubiergo Sebastián
- Critical Care Department, Clínica Indisa, Universidad Andrés Bello, Santiago de Chile, Chile; FEPIMCTI, Council WFSICCM, Chile
| | | | | | - Angela Cubides
- Universidad Santiago de Cali, Cali, Colombia; Universidad del Valle, Cali, Colombia
| | - Angélica F Luna
- General Critical Care Unit and Intermediate Care, Neiva, Colombia
| | - Max Arroyo-Parejo
- Hospital Privado Clínica Santa Sofía, Caracas, Venezuela; Hospital Vargas de Caracas, Caracas, Venezuela
| | | | | | - Orlando Ch Villareal
- Clínica Evaluamos, Córdoba, Colombia; Facultad de Medicina, Universidad del Sinú, Córdoba, Colombia
| | - Oscar S Pinillos
- Metabolic Disorders and Intensive Care Research Group, Cali, Colombia
| | - Elías Vieda
- Hospital Universitario del Valle, Cali, Colombia
| | - Manuel Bello
- Critical Care Department, Hospital Nacional San Rafael, San Salvador, El Salvador; Salvadorean Critical Care Association, El Salvador
| | - Susana Peña
- Ministry of Health, San Salvador, El Salvador
| | | | | | - Jorge L M Ranero
- Hospital General de Enfermedades, Instituto Guatemalteco de Seguridad Social, Guatemala City, Guatemala
| | | | - Sandra G Olaya
- Obstetric and Gynecologic Intensive Care Unit, Hospital San Jorge Pereira, Colombia
| | - José C Vergara
- Hospital Luis Vernaza, Holy Spirit University of Guayaquil Ecuador, Guayaquil, Ecuador; Universidad Espíritu Santo de Guayaquil, Ecuador
| | - Ana Tandazo
- Hospital Luis Vernaza, Holy Spirit University of Guayaquil Ecuador, Guayaquil, Ecuador; Universidad Espíritu Santo de Guayaquil, Ecuador
| | | | | | - R A Fowler
- Clinical Epidemiology, Sunnybrook Research Institute, Canada; Sunnybrook Health Sciences Centre, Canada; Department of Medicine and Interdepartmental Division of Critical Care Medicine, University of Toronto, Canada
| | - John C Marshall
- Surgery, University of Toronto, Canada; Michael Hospital, Toronto, Canada
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Forsberg A, Widén-Holmqvist L, Ahlström G. Balancing everyday life two years after falling ill with Guillain-Barré syndrome: a qualitative study. Clin Rehabil 2014; 29:601-10. [DOI: 10.1177/0269215514549564] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Accepted: 08/09/2014] [Indexed: 11/16/2022]
Abstract
Purpose: The aim was to describe experiences of disability in everyday life and managing the recovery process two years after falling ill with Guillain-Barré syndrome. Design: Qualitative interview study. Methods: Interviews were conducted with 35 persons (22 male, mean age 50 years) two years after the onset of Guillain-Barré syndrome. The interviews were transcribed verbatim and analysed using content analysis. Results: The analysis revealed four categories and an overall theme: ‘Striving for balance in everyday life’. The participants described persistent lived body restrictions that affected their arms, legs, and face. Bodily symptoms and loss of energy limited or restricted many everyday activities. In connection with healthcare, both satisfaction and feeling vulnerable in a critical situation were described. Experiences of the recovery process varied. The participants described acceptance and reappraisal of a new life situation despite their limitations, and having gained the knowledge that life can change suddenly. However, they also expressed disappointment following an overly positive prognosis in the early stages, and over a continuous wait for recovery. For some participants life had returned to as before. Conclusion: The participants experienced limitations in everyday life and decreased functioning in several parts of the body. The recovery process may still be ongoing two years after onset. Rehabilitation intervention with an extended focus on supporting individualized coping processes could facilitate ways to live with persistent disability.
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Affiliation(s)
- Anette Forsberg
- Division of Neurology, Karolinska Institutet, Stockholm, Sweden
- Family Medicine Research Centre, Örebro County Council, Örebro, Sweden
| | - Lotta Widén-Holmqvist
- Division of Neurology, Karolinska Institutet, Stockholm, Sweden
- Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
| | - Gerd Ahlström
- Department of Health Sciences, Lund University, Lund, Sweden
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Kerasnoudis A, Pitarokoili K, Behrendt V, Gold R, Yoon MS. Correlation of nerve ultrasound, electrophysiological, and clinical findings in post Guillain-Barré syndrome. J Peripher Nerv Syst 2014; 18:232-40. [PMID: 24028191 DOI: 10.1111/jns5.12037] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2013] [Revised: 07/14/2013] [Accepted: 07/29/2013] [Indexed: 12/30/2022]
Abstract
We aimed to correlate functional disability, electrophysiology, and nerve ultrasound in patients after Guillain-Barré syndrome (GBS). Seventy-five healthy controls and 41 post-GBS patients (mean 3.4 years, SD ± 2.91 years after onset) underwent clinical, sonographic, and electrophysiological evaluation. Compared to healthy controls, the post-GBS patients showed: (1) a mean Rasch-built Overall Disability Scale score of 31.8 (SD ± 11.6), modified Rasch-built fatigue severity scale score of 15.6 (SD ± 3.2), Medical Research Council sum score of 22 (SD ± 5.6); (2) electrophysiological signs of permanent axonal loss in the majority of the peripheral nerves; (3) sonographical evidence of higher cross-sectional area values (CSA) of the ulnar (elbow, p < 0.001), radial (spiral groove, p < 0.001), tibial nerve (popliteal fossa, p < 0.001) and brachial plexus (supraclavicular space, p < 0.001). No correlation between sonographic and electrophysiological findings was found. Neither nerve ultrasound nor electrophysiology correlated with muscle strength, overall disability, and fatigue scale. Compared to healthy controls, post-GBS patients had significant functional disability. Despite significant abnormalities in both electrophysiology and ultrasound compared to healthy controls, neither electrophysiology nor nerve ultrasound correlated with functional disability of these patients.
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Affiliation(s)
- Antonios Kerasnoudis
- Department of Neurology, St. Josef Hospital, Ruhr University of Bochum, Bochum, Germany
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Sendhilkumar R, Gupta A, Nagarathna R, Taly AB. “Effect of pranayama and meditation as an add-on therapy in rehabilitation of patients with Guillain-Barré syndrome—a randomized control pilot study”. Disabil Rehabil 2012; 35:57-62. [PMID: 22621705 DOI: 10.3109/09638288.2012.687031] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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