Successful Rehabilitation of Patient With COVID-19-linked Guillain-Barré Syndrome

Intensive physical and occupational therapy targeted at patient-specific deficits allowed an independent long-term acute care hospital (LTACH) to successfully rehabilitate and discharge a man diagnosed with Guillain-Barré syndrome following COVID-19 infection, according to a case report published in JMIR Rehabilitation and Assistive Technologies.

“The treatment strategies described here are informed by the LTACH’s long history of treating patients with GBS,” wrote authors from Gaylord Specialty Healthcare in Wallingford, Connecticut. “Since the start of the COVID-19 pandemic (March 2020-March 2021), this facility has treated 23 patients for GBS, 5 (21%) of which, including the case described here, were COVID-19-associated GBS cases.”

According to the report, the 61-year-old man fell during a telehealth appointment after a COVID-19 diagnosis and lacked the strength to stand. He called emergency services and was transported to an acute care hospital, where he was diagnosed and treated for GBS. Afterward, he was transferred to the LTACH for rehabilitation.

Physical and occupational therapy led to improvements in upper and lower extremity strength, as well as marked gains in fine motor control and coordination.

“The patient’s functional mobility improved from being dependent and unable to ambulate or perform transfers to ambulation with a contact guard and transfers with supervision,” the authors wrote. “This led to functional improvements, independence with activities of daily living, improved Activity Measure for Postacute Care scores for both the mobility and activities of daily living sections, and a safe discharge home.”

Rehabilitation included individual occupational therapy and physical therapy sessions, combined occupational-physical therapy sessions, and group therapy sessions that focused on leg, arm, and fine motor coordination exercises. Therapists challenged the patient but were also careful to avoid overfatigue and potential setbacks in recovery. After resting on weekends, the patient showed notable increases in strength.

“’I was somewhat traumatized from the 8 days in the [acute care] hospital all alone, but once I realized that everyone at Gaylord was looking out for me, I was able to relax and just focus on getting better,’” the man said in the case report. “‘I worked hard to maintain a positive attitude and to talk with other patients and staff to get encouragement and strength from them so I could reflect on it each night, which was the most difficult time for me.”

“This mentality,” the authors reflected, “helped the patient to overcome the obstacles he faced during rehabilitation and make a remarkable recovery.”

Reference:
Connors C, McNeill S, Hrdlicka HC. Occupational and physical therapy strategies for the rehabilitation of COVID-19-related Guillain-Barré syndrome in the long-term acute care hospital setting: case report. JMIR Rehab Assist Technol. 2022;9(1):e30794. doi:10.2196/30794